Suwiński Rafał, Bańkowska-Woźniak Magdalena, Majewski Wojciech, Idasiak Adam, Maciejewski Adam, Ziółkowska Ewa, Windorbska Wiesława, Składowski Krzysztof, Miszczyk Leszek, Maciejewski Bogusław
Department of Radiation Oncology, M. Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Gliwice, Poland.
Radiother Oncol. 2008 May;87(2):155-63. doi: 10.1016/j.radonc.2008.02.009. Epub 2008 Mar 14.
To evaluate the normal tissue reactions and loco-regional control rates (LRC) in patients treated with 7-days-a-week postoperative continuous irradiation (p-CAIR) compared to conventionally fractionated 5-days-a-week postoperative radiotherapy (CF).
MATERIALS/METHODS: Between 2001 and 2004, 279 patients with high-risk squamous cell cancer of the larynx (158 pts.) or cancer of the oral cavity/oropharynx (121 pts.) were enrolled. They were stratified according to the primary cancer site (larynx vs. others) and the treating center and randomized to receive 63 Gy in fractions of 1.8 Gy given 5-days-a-week (140 pts: CF) or 7-days-a-week (139 pts: p-CAIR).
The acute and late toxicity was considered acceptable, although the proportion of patients with confluent mucositis was higher in p-CAIR compared to CF (60.0 vs. 33.3%). The actuarial 3-year LRC were 64 vs. 70% for CF and p-CAIR, respectively, p=0.32. A statistically significant improvement in 3-year LRC in p-CAIR arm appeared in a subset of the patients with cancer of the oropharynx/oral cavity (74% p-CAIR vs. 53% CF, p=0.02). By contrast, there was no improvement in LRC in a subset of the patients with cancer of the larynx (p=0.46).
An improvement in LRC attributable to acceleration of postoperative radiotherapy appeared restricted to the patients with cancer of the oropharynx/oral cavity. In patients with cancer of the larynx acceleration of postoperative radiotherapy did not have any beneficial effect.
评估每周连续7天术后放疗（p-CAIR）与传统的每周5天分割术后放疗（CF）相比，患者的正常组织反应和局部区域控制率（LRC）。
材料/方法：2001年至2004年期间，纳入了279例高危喉鳞状细胞癌患者（158例）或口腔/口咽癌患者（121例）。根据原发癌部位（喉癌与其他部位）和治疗中心进行分层，并随机分为两组，一组每周5天接受1.8 Gy分割的63 Gy放疗（140例：CF），另一组每周7天接受放疗（139例：p-CAIR）。
尽管p-CAIR组中出现融合性粘膜炎的患者比例高于CF组（60.0%对33.3%），但急性和晚期毒性被认为是可接受的。CF组和p-CAIR组的3年精算LRC分别为64%和70%，p = 0.32。在口咽/口腔癌患者亚组中，p-CAIR组的3年LRC有统计学显著改善（p-CAIR组为74%，CF组为53%，p = 0.02）。相比之下，喉癌患者亚组的LRC没有改善（p = 0.46）。
术后放疗加速导致的LRC改善似乎仅限于口咽/口腔癌患者。对于喉癌患者，术后放疗加速没有任何有益效果。
