Rades Dirk, Fehlauer Fabian, Wroblesky Junes, Albers Dirk, Schild Steven E, Schmidt Rainer
Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Oral Oncol. 2007 Jul;43(6):535-43. doi: 10.1016/j.oraloncology.2006.05.006. Epub 2006 Sep 26.
In 148 head-and-neck cancer patients treated with surgery plus radiotherapy (RT), IMRT, 3D-conformal RT, and conventional RT and 10 potential prognostic factors were evaluated for overall survival (OS), metastasis-free survival (MFS), and loco-regional control (LC). On univariate analysis, ECOG performance status, T-stage, AJCC-stage, extent of resection, and pre-RT hemoglobin level (>or=12 g/dl better than <12 g/dl) were significantly associated with treatment outcome, whereas RT technique had no significant impact. On multivariate analysis, performance status maintained significance for OS (P=0.019), AJCC-stage for LC (P=0.034), extent of resection for OS (P=0.045) and MFS (P=0.021), pre-RT hemoglobin for MFS (P<0.001). IMRT was associated with less xerostomia than conformal RT and conventional RT (17% versus 63% and 73%, P=0.037). Otherwise, acute and late toxicity was similar. Outcome was significantly associated with performance status, tumor stage, extent of resection, and pre-RT hemoglobin. The three radiation techniques provided similar disease control. IMRT was effective in significantly reducing xerostomia.
在148例接受手术加放疗（RT）、调强放疗（IMRT）、三维适形放疗（3D - conformal RT）和传统放疗的头颈癌患者中，对10个潜在的预后因素进行了总生存期（OS）、无转移生存期（MFS）和局部区域控制（LC）的评估。单因素分析显示，美国东部肿瘤协作组（ECOG）体能状态、T分期、美国癌症联合委员会（AJCC）分期、切除范围以及放疗前血红蛋白水平（≥12 g/dl优于＜12 g/dl）与治疗结果显著相关，而放疗技术无显著影响。多因素分析显示，体能状态对OS仍具有显著意义（P = 0.019），AJCC分期对LC具有显著意义（P = 0.034），切除范围对OS（P = 0.045）和MFS（P = 0.021）具有显著意义，放疗前血红蛋白对MFS具有显著意义（P＜0.001）。与适形放疗和传统放疗相比，IMRT导致的口干症较少（17% 对比63%和73%，P = 0.037）。此外，急性和晚期毒性相似。结果与体能状态、肿瘤分期、切除范围和放疗前血红蛋白显著相关。三种放疗技术提供了相似的疾病控制效果。IMRT在显著减少口干症方面有效。
