Dinshaw K A, Sharma V, Agarwal J P, Ghosh S, Havaldar R
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
Int J Radiat Oncol Biol Phys. 2000 Oct 1;48(3):723-35. doi: 10.1016/s0360-3016(00)00635-0.
To evaluate the influence of various treatment parameters on local control as well as complications in T1 and T2 glottic carcinomas.
Between 1975 and 1989, 676 patients with early glottic carcinoma (460 T1 and 216 T2) received curative radiation with three different treatment regimens, as follows: Regimen 1-50 Gy/15 Fr/3 weeks (3.33 Gy/daily) for 192 patients; Regimen 2-60-62.5 Gy/24-25 Fr/5 weeks (2.5 Gy/daily) for 352 patients; and Regimen 3-55-60 Gy/25-30 Fr/5-6 weeks (2-2.25 Gy/daily) for 132 patients.
The local control at 10 years was 82% and 57% for T1 and T2 lesions respectively (p = 0.0). For the T1N0M0 group, field size had significant impact on local control with both univariate (p = 0.05) and multivariate (p = 0.03) analysis. For T2N0M0, group field size (p = 0.03) as well as registration year (p = 0.016) were significant in univariate analysis whereas only field size remained significant on multivariate analysis. Persistent radiation edema was noted in 146 (22%) patients and was significantly worse with larger field size (p = 0.000) but not related to different treatment regimens.
The shorter fractionation schedule had comparable local control, without increased complications in comparison to the protracted schedule and is best suited for a busy department.
评估不同治疗参数对T1和T2声门癌局部控制及并发症的影响。
1975年至1989年间，676例早期声门癌患者（460例T1期和216例T2期）接受了三种不同治疗方案的根治性放疗，具体如下：方案1-192例患者接受50 Gy/15次分割/3周（每日3.33 Gy）；方案2-352例患者接受60 - 62.5 Gy/24 - 25次分割/5周（每日2.5 Gy）；方案3-132例患者接受55 - 60 Gy/25 - 30次分割/5 - 6周（每日2 - 2.25 Gy）。
T1和T2病变10年局部控制率分别为82%和57%（p = 0.0）。对于T1N0M0组，单因素（p = 0.05）和多因素（p = 0.03）分析均显示照射野大小对局部控制有显著影响。对于T2N0M0组，单因素分析中照射野大小（p = 0.03）以及登记年份（p = 0.016）有显著意义，而多因素分析中仅照射野大小仍具有显著意义。146例（22%）患者出现持续性放射性水肿，照射野越大情况越严重（p = 0.000），但与不同治疗方案无关。
与延长分割方案相比，短分割方案具有相当的局部控制率，且并发症未增加，最适合繁忙的科室。
