Krstevska V, Smichkoska S
Institute of Radiotherapy and Oncology, Clinical Centre, Medical Faculty, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
Prilozi. 2006 Dec;27(2):175-87.
The aim of the study was to investigate the efficacy of hyperfractionation as an altered fractionation treatment schedule in comparison with conventional fractionation in primary definitive radiotherapy for laryngeal squamous cell carcinoma. From March 1999 to December 2000, a group of 28 patients with previously untreated squamous cell carcinoma of the larynx were irradiated with conventional fractionation to total doses of 66 to 70 Gy in 33 to 35 fractions/6.5 to 7 weeks, 2 Gy/fraction/day, 5 days/week. From January 2001 to June 2004, the other 27 patients with the same diagnosis, were treated prospectively with hyperfractionation receiving radiotherapy delivered at 1.2 Gy/fraction, twice daily, 5 days/week to 74.4 to 79.2 Gy/62 to 66 fractions/6.2 to 7 weeks. Complete response rates after two months of radiotherapy completion were 78.6% (22 of 28) and 66.7% (18 of 27) in the conventional fractionation and hyperfractionation group, respectively (Fisher exact test; P=0.246). The two year loco-regional control rates were 61.0% +/- 18.1 (95% CI) in the conventional fractionation group and 45.0% +/- 18.8 (95% CI) in the hyperfractionation group (log-rank test; P=0.075). Overall survival rate at two years was 71.0% +/- 16.8 (95% CI) for the conventional fractionation group and 43.0% +/- 18.7 (95% CI) for the hyperfractionation group (log-rank test; P=0.071). The absence of statistically significant differences either in loco-regional control or overall survival observed between the two treatment modalities suggested that hyperfractionation regimen was not more efficacious than conventionally fractionated radiotherapy for previously untreated carcinoma of the larynx.
本研究旨在探讨超分割作为一种改变分割治疗方案，与传统分割相比，在喉鳞状细胞癌的原发性根治性放疗中的疗效。1999年3月至2000年12月，一组28例未经治疗的喉鳞状细胞癌患者接受传统分割放疗，总剂量为66至70 Gy，分33至35次/6.5至7周，每次2 Gy/天，每周5天。2001年1月至2004年6月，另外27例诊断相同的患者接受前瞻性超分割放疗，每次1.2 Gy，每天两次，每周5天，总剂量为74.4至79.2 Gy/62至66次/6.2至7周。放疗完成两个月后的完全缓解率在传统分割组和超分割组分别为78.6%（28例中的22例）和66.7%（27例中的18例）（Fisher精确检验；P = 0.246）。传统分割组的两年局部区域控制率为61.0%±18.1（95%CI），超分割组为45.0%±18.8（95%CI）（对数秩检验；P = 0.075）。传统分割组的两年总生存率为71.0%±16.8（95%CI），超分割组为43.0%±18.7（95%CI）（对数秩检验；P = 0.071）。两种治疗方式在局部区域控制或总生存方面均未观察到统计学上的显著差异，这表明对于未经治疗的喉癌，超分割方案并不比传统分割放疗更有效。
