Langendijk Johannes A, Bourhis Jean
Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands.
Curr Opin Oncol. 2007 May;19(3):202-9. doi: 10.1097/CCO.0b013e3280f00ff8.
The purpose of this review is to highlight the most important developments in the management of recurrent or second primary head and neck carcinoma in previously irradiated areas by reirradiation that have been published in the medical literature in the past year.
Recent research indicates that long-term survival can be achieved in a proportion of patients using more advanced chemo-reirradiation protocols in the primary as well as in postoperative reirradiation setting. Despite the promising results with regard to locoregional tumour control and survival, treatment-related acute and late morbidity remains of major concern.
As an increasing number of patients currently receive more effective initial treatment regimens, recurrent and second primary tumours in previously irradiated areas nowadays may represent a more radio-resistant population than reported in previous studies. Therefore, full-dose chemo-reirradiation should only be applied in well selected cases.
本综述旨在强调过去一年在医学文献中发表的关于对先前接受过放疗区域的复发性或第二原发性头颈癌进行再放疗管理方面最重要的进展。
近期研究表明,在原发性以及术后再放疗情况下,使用更先进的化疗再放疗方案,部分患者可实现长期生存。尽管在局部区域肿瘤控制和生存方面取得了令人鼓舞的结果,但与治疗相关的急性和晚期发病率仍然是主要关注点。
由于目前越来越多的患者接受了更有效的初始治疗方案,与先前研究报道相比,先前接受过放疗区域的复发性和第二原发性肿瘤患者如今可能表现出更高的放射抗性。因此,全剂量化疗再放疗应仅在精心挑选的病例中应用。