Combs Stephanie E, Behnisch Wolfgang, Kulozik Andreas E, Huber Peter E, Debus Jürgen, Schulz-Ertner Daniela
University of Heidelberg, Department of Radiation Oncology, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
BMC Cancer. 2007 Sep 13;7:177. doi: 10.1186/1471-2407-7-177.
The present study evaluates the outcome of 19 children with rhabdomyosarcoma of the head-and-neck region treated with Intensity Modulated Radiotherapy (IMRT) or Fractionated Stereotactic Radiotherapy (FSRT) between August 1995 and November 2005.
We treated 19 children with head-and-neck rhabdomyosarcoma with FSRT (n = 14) or IMRT (n = 5) as a part of multimodal therapy. Median age at the time of radiation therapy was 5 years (range 2-15 years). All children received systemic chemotherapy according to the German Soft Tissue Sarcoma Study protocols. Median size of treatment volume for RT was 93,4 ml. We applied a median total dose of 45 Gy (range 32 Gy - 54 Gy) using a median fractionation of 5 x 1,8 Gy/week (range 1,6 Gy - 1,8 Gy). The median time interval between primary diagnosis and radiation therapy was 5 months (range 3-9 months).
After RT, the 3- and 5-year survival rate was 94%. The 3- and 5-year actuarial local control rate after RT was 89%. The actuarial freedom of distant metastases rate at 3- and 5-years was 89% for all patients. Radiotherapy was well tolerated in all children and could be completed without interruptions > 4 days. No toxicities >CTC grade 2 were observed. The median follow-up time after RT was 17 months.
IMRT and FSRT lead to excellent outcome in children with head-and-neck RMS with a low incidence of treatment-related side effects.
本研究评估了1995年8月至2005年11月间接受调强放射治疗(IMRT)或分次立体定向放射治疗(FSRT)的19例头颈部横纹肌肉瘤患儿的治疗结果。
作为多模式治疗的一部分,我们用FSRT(n = 14)或IMRT(n = 5)治疗了19例头颈部横纹肌肉瘤患儿。放疗时的中位年龄为5岁(范围2 - 15岁)。所有患儿均根据德国软组织肉瘤研究方案接受全身化疗。放疗的中位治疗体积为93.4毫升。我们采用中位总剂量45 Gy(范围32 Gy - 54 Gy),中位分割为每周5次,每次1.8 Gy(范围1.6 Gy - 1.8 Gy)。初次诊断与放疗之间的中位时间间隔为5个月(范围3 - 9个月)。
放疗后,3年和5年生存率为94%。放疗后的3年和5年精算局部控制率为89%。所有患者3年和5年远处转移精算无病生存率为89%。所有患儿对放疗耐受性良好,可在无>4天中断的情况下完成治疗。未观察到>CTC 2级的毒性反应。放疗后的中位随访时间为17个月。
IMRT和FSRT对头颈部横纹肌肉瘤患儿疗效极佳,治疗相关副作用发生率低。