头颈部癌的姑息性放射治疗：迈向最佳分割方案
Palliative radiation therapy for head and neck cancer: toward an optimal fractionation scheme.
作者信息
Chen Allen M, Vaughan Andrew, Narayan Samir, Vijayakumar Srinivasan
机构信息
Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, California 95817, USA.
出版信息
Head Neck. 2008 Dec;30(12):1586-91. doi: 10.1002/hed.20894.
BACKGROUND
To analyze the efficacy of various fractionation schedules for the palliation of head and neck cancer with radiation therapy.
METHODS
Sixty patients completed palliative irradiation to primary head and neck sites. The most commonly used fractionation regimen was the one previously described by the Radiation Therapy Oncology Group (RTOG) protocol 85-02 and was designed to deliver 440 cGy using 370 cGy fractionation, administered twice a day for 2 consecutive days at 2- to 3-week intervals for 3 total cycles.
RESULTS
The rates of palliative response were 83%, 77%, 67%, 86%, and 60% among those treated using the RTOG regimen, 7000 cGy/35 fractions, 3000 cGy/10 fractions, 3750 cGy/15 fractions, and 2000 cGy/5 fractions, respectively (p = .42). Nine percent (2/23) of those treated with the RTOG regimen developed grade 3+ toxicity compared with 37% among those treated with other schedules (p = .01).
CONCLUSION
Although all of the analyzed schedules were effective at providing palliation, the RTOG 85-02 regimen was associated with less toxicity.
背景
分析不同分割方案在头颈部癌放射治疗姑息治疗中的疗效。
方法
60例患者完成了对头颈部原发部位的姑息性放疗。最常用的分割方案是放射治疗肿瘤学组（RTOG）85 - 02方案中先前描述的方案，设计为采用370 cGy分割，每次给予440 cGy，连续2天每天给予2次，间隔2至3周，共进行3个周期。
结果
采用RTOG方案、7000 cGy/35次分割、3000 cGy/10次分割、3750 cGy/15次分割和2000 cGy/5次分割治疗的患者姑息反应率分别为83%、77%、67%、86%和60%（p = 0.42）。采用RTOG方案治疗的患者中有9%（2/23）发生3级及以上毒性反应，而采用其他方案治疗的患者中这一比例为37%（p = 0.01）。
结论
虽然所有分析的方案在提供姑息治疗方面均有效，但RTOG 85 - 02方案的毒性较小。
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