T2N0期声门癌的超分割放疗：对60例连续患者进行10年随访的回顾性分析

Hyperfractionated radiotherapy for T2N0 glottic carcinoma: a retrospective analysis at 10 years follow-up in a series of 60 consecutive patients.

作者信息

Bignardi Mario, Antognoni Paolo, Sanguineti Giuseppe, Magli Alessandro, Molteni Marinella, Merlotti Anna, Richetti Antonella, Tordiglione Michele, Conte Leopoldo, Magno Lorenzo

机构信息

Department of Radiotherapy, Spedali Civili, Brescia, Italy.

出版信息

Tumori. 2004 May-Jun;90(3):317-23. doi: 10.1177/030089160409000310.

DOI:10.1177/030089160409000310

PMID:15315312

Abstract

AIMS AND BACKGROUND

To report results of hyperfractionated radiotherapy for T2N0 glottic carcinoma at a single institution after extended follow-up.

METHODS

Between 1980 and 1988 at Varese University Hospital, 60 consecutive patients with T2N0 glottic carcinoma received exclusive radiotherapy consisting of 1.5 Gy/fraction twice a day. Treatment gaps during the radiotherapy course were allowed according to individual tolerance. This policy resulted in a wide range of elapsed treatment time: median, 5.7 weeks; range, 3.7-8.9. Median follow-up is 9.8 years.

RESULTS

As a result of dose/time distribution, 16, 20 and 24 patients received an average weekly dose rate of <10 Gy/week, equal to 10 Gy/week or >10 Gy/week, respectively. Mean total dose for each group was 62.8 Gy, 63.7 Gy and 63.8 Gy, respectively. Five-year local-regional control was 69 +/- 6% (95% CI); ultimate local-regional control, including salvage surgery, was 78 +/- 5%. All failures were at the primary site, and no patient developed neck recurrence as first site of failure. The actuarial incidence of grade 2-3 late reactions at 5 years was 42 +/- 6%. Most late toxicity events were grade 2: only 2 patients developed grade 3 reactions and none grade 4. None of the several clinical and treatment-related variables showed any statistically significant impact on local-regional control or late toxicity at univariate and multivariate analysis. In particular, 3-year local-regional control rates were 73 +/- 11%, 84 +/- 8% and 69 +/- 10% for an average weekly dose rate of <10 Gy/week, equal to 10 Gy/week and >10 Gy/week, respectively (not significantly different).

CONCLUSIONS

At a very long follow-up, the hyperfractionated regimen tested in the study was shown to be effective and devoid of major complications, provided individual patient acute tolerance is carefully taken into account. Also, time factor did not affect outcome in this series.

摘要

目的与背景

报告在一家机构对T2N0声门癌进行超分割放疗并延长随访后的结果。

方法

1980年至1988年期间，在瓦雷泽大学医院，60例连续的T2N0声门癌患者接受了单纯放疗，每次分割剂量为1.5 Gy，每天两次。放疗过程中根据个体耐受性允许有治疗间隙。这一策略导致治疗时间差异很大：中位数为5.7周；范围为3.7 - 8.9周。中位随访时间为9.8年。

结果

由于剂量/时间分布，16例、20例和24例患者平均每周剂量率分别<每周10 Gy、等于每周10 Gy或>每周10 Gy。每组的平均总剂量分别为62.8 Gy、63.7 Gy和63.8 Gy。5年局部区域控制率为69±6%（95%置信区间）；包括挽救性手术在内的最终局部区域控制率为78±5%。所有失败均发生在原发部位，没有患者以颈部复发作为首个失败部位。5年时2 - 3级晚期反应的精算发生率为42±6%。大多数晚期毒性事件为2级：只有2例患者出现3级反应，无4级反应。在单因素和多因素分析中，几个临床和治疗相关变量均未显示对局部区域控制或晚期毒性有任何统计学显著影响。特别是，平均每周剂量率<每周10 Gy、等于每周10 Gy和>每周10 Gy时，3年局部区域控制率分别为73±11%、84±8%和69±10%（无显著差异）。