Miralbell R, Allal A S, Mermillod B, Pastoors B
Radiation Oncology Department, University Hospital of Geneva, Switzerland.
Strahlenther Onkol. 1999 Feb;175(2):74-7. doi: 10.1007/BF02753846.
Accelerated radiotherapy and/or chemo-radiotherapy of the head and neck region decrease the tolerance of acute responding tissues. Tissue tolerance is also field size dependent.
An attempt to retrospectively quantify the risk of acute toxicity (peak scores) with field size was undertaken in 286 patients irradiated for unresected head and neck tumors with or without chemotherapy, and with or without accelerated radiotherapy between 1979 and 1990. A Grade-3 to -4 acute toxicity score (RTOG) and > 5% weight loss were chosen as endpoints.
For Grade-3 to -4 toxicity, the risk increased from 0.06 for 5 x 5 cm2 to 0.68 for 17 x 17 cm2 fields and conventional radiotherapy, and from 0.33 for 5 x 5 cm2 to 0.94 for 17 x 17 cm2 and multiple daily fractionation. For > 5% weight loss, the risk ranged from 0.07 for 5 x 5 cm2 to 0.94 for 17 x 17 cm2 fields.
The size of the cervical fields receiving the first 50 Gy was an indicator for severe acute toxicity and weight loss. Taking these data into account may help to improve preventive and treatment measures.
头颈部区域的加速放疗和/或放化疗会降低急性反应组织的耐受性。组织耐受性也与照射野大小有关。
对1979年至1990年间接受未切除头颈部肿瘤放疗的286例患者进行回顾性研究，试图量化照射野大小与急性毒性（峰值评分）风险之间的关系，这些患者接受或未接受化疗，以及接受或未接受加速放疗。选择3至4级急性毒性评分（RTOG）和体重减轻>5%作为终点指标。
对于3至4级毒性，在常规放疗中，照射野面积从5×5平方厘米时的0.06增加到17×17平方厘米时的0.68；在每日多次分割放疗中，照射野面积从5×5平方厘米时的0.33增加到17×17平方厘米时的0.94。对于体重减轻>5%，照射野面积从5×5平方厘米时的0.07到17×17平方厘米时的0.94不等。
接受前50 Gy照射的颈部照射野大小是严重急性毒性和体重减轻的一个指标。考虑这些数据可能有助于改进预防和治疗措施。
