Department of Radiation Oncology, Chang Gung Memorial Hospital, Chia-Yi, #6, Chia-Pu Road, Putz City, Chiayi, Hsien, Taiwan.
Oral Oncol. 2009 Jun;45(6):505-10. doi: 10.1016/j.oraloncology.2008.07.002. Epub 2008 Sep 19.
The aim of this study was to assess the treatment results and toxicity profiles of post-operative conventional radiotherapy (Conv-RT) and intensity-modulated radiotherapy (IMRT) for stage III and IV oral cavity cancer. During the period from April 2002 to December 2005, a total of 49 patients with stage III and IV squamous cell carcinoma of the oral cavity were treated with radical surgery followed by post-operative RT. Twenty-seven patients received Conv-RT while 22 received IMRT. Only three patients received adjuvant chemotherapy. With a median follow-up time of 3.3 years, the 3-year overall survival and disease-free survival rates for patients who received Conv-RT vs IMRT were comparable. There was no significant difference in acute toxicity between the two different RT techniques. However, in terms of late toxicity, patients receiving IMRT had significantly less moderate to severe xerostomia and dysphagia than those receiving Conv-RT (36% vs 82%, p=0.01 for xerostomia and 21% vs 59%, p=0.02 for dysphagia). Post-operative Conv-RT and IMRT are equally effective in terms of tumor control for locally advanced oral cavity cancer. Patients receiving IMRT had comparable acute and significant less late toxicity than those receiving Conv-RT.
本研究旨在评估 III 期和 IV 期口腔癌术后常规放疗（Conv-RT）和调强放疗（IMRT）的治疗效果和毒性谱。2002 年 4 月至 2005 年 12 月期间，共对 49 例 III 期和 IV 期口腔鳞状细胞癌患者进行了根治性手术，术后接受了放疗。27 例患者接受了 Conv-RT，22 例患者接受了 IMRT。仅 3 例患者接受了辅助化疗。中位随访时间为 3.3 年，接受 Conv-RT 与 IMRT 的患者 3 年总生存率和无病生存率相当。两种不同放疗技术的急性毒性无显著差异。然而，在晚期毒性方面，接受 IMRT 的患者的中重度口干和吞咽困难明显少于接受 Conv-RT 的患者（口干症：36%比 82%，p=0.01；吞咽困难：21%比 59%，p=0.02）。术后 Conv-RT 和 IMRT 在局部晚期口腔癌的肿瘤控制方面同样有效。接受 IMRT 的患者与接受 Conv-RT 的患者相比，急性毒性相当，晚期毒性明显减少。
