Schwartz Matthew, Vuong Té, Ballivy Olivier, Parker William, Patrocinio Horacio
Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec, Canada.
Otolaryngol Head Neck Surg. 2007 Apr;136(4):549-55. doi: 10.1016/j.otohns.2006.10.044.
To determine the feasibility and toxicity profile of accelerated radiotherapy with a simultaneous integrated boost fractionation scheme with intensity-modulated radiotherapy (SIB-IMRT) with or without chemotherapy.
Forty-nine patients with advanced head and neck cancer underwent SIB-IMRT. Concomitant chemotherapy was administered in 29 patients.
Grade 3 acute toxicities included 55% mucositis, 20% odynophagia, 12% nausea, 18% hematologic, and 8% skin. There were no grade 4 toxicities or treatment-related deaths. With a median follow-up of 25 months, locoregional control was 83%, and overall survival was 80%. Of patients with grade 3 late toxicities, two patients (4% of the total) required a permanent percutaneous endoscopic gastrostomy tube, and osteonecrosis occurred in one patient (2% of the total).
SIB-IMRT is a feasible technique that shortens the overall treatment time in the radical treatment of patients with advanced head and neck cancer while maintaining acceptable rates of acute toxicity in this study. Although the results are promising, this approach should be considered only in the setting of a clinical trial.
确定采用同步整合加量调强放疗（SIB-IMRT）联合或不联合化疗的加速放疗方案的可行性和毒性特征。
49例晚期头颈癌患者接受了SIB-IMRT治疗。29例患者接受了同步化疗。
3级急性毒性反应包括55%的黏膜炎、20%的吞咽痛、12%的恶心、18%的血液学毒性和8%的皮肤毒性。无4级毒性反应或与治疗相关的死亡。中位随访25个月时，局部区域控制率为83%，总生存率为80%。在发生3级晚期毒性反应的患者中，2例患者（占总数的4%）需要永久性经皮内镜下胃造瘘管，1例患者（占总数的2%）发生骨坏死。
SIB-IMRT是一种可行的技术，在晚期头颈癌患者的根治性治疗中可缩短总治疗时间，同时在本研究中保持可接受的急性毒性发生率。尽管结果令人鼓舞，但这种方法仅应在临床试验的背景下考虑。
