Sakata Koh-ichi, Someya Masanori, Hori Masakazu, Nakata Kensei, Takagi Masaru, Hareyama Masato
Department of Radiology, Sapporo Medical University, School of Medicine, S1W16, Chuo-Ku, Sapporo, 060-8543, Japan.
Strahlenther Onkol. 2008 Jul;184(7):364-9. doi: 10.1007/s00066-008-1819-1. Epub 2008 Oct 1.
Hyperfractionated accelerated radiotherapy without a split (AF) has been performed to improve the local control probability of early glottic carcinomas since 1990 in the authors' institution. Here, they report their experience treating early glottic cancer patients with AF in a single institution who have a long follow-up period.
131 T1 N0 M0 glottic cancers and 65 T2 N0 M0 glottic cancers were treated with conventional fractionation (CF) from 1984 to 1989 and with AF since 1990. CF consisted of five daily fractions of 2 Gy per week, to a total dose of 64 Gy. AF consisted of 1.72 Gy per fraction, two fractions per day, 5 days a week, to a total dose of 55 or 58.5 Gy.
The 5-year local control probability for T1 tumors was 94% with 58.5 Gy and 87% with 55 Gy of AF, whereas it amounted to 80% with CF. For T2 tumors, it was 56% with 58.5 Gy and 68% with 55 Gy of AF, whereas it amounted to 64% with CF. The data of T2 should be evaluated with caution due to the small number of patients. Patients with AF had more severe mucosal reactions but no severe late reactions.
AF significantly improved the local control rates for T1 glottic cancer.
自1990年起，作者所在机构开展了不分次的超分割加速放疗（AF），以提高早期声门癌的局部控制率。在此，他们报告在单一机构对早期声门癌患者进行AF治疗且随访期较长的经验。
1984年至1989年，131例T1 N0 M0声门癌和65例T2 N0 M0声门癌采用常规分割放疗（CF），自1990年起采用AF。CF为每周5次，每次2 Gy，总剂量64 Gy。AF为每次1.72 Gy，每天2次，每周5天，总剂量55或58.5 Gy。
T1肿瘤采用58.5 Gy的AF时5年局部控制率为94%，采用55 Gy时为87%，而CF为80%。对于T2肿瘤，采用58.5 Gy的AF时为56%，采用55 Gy时为68%，而CF为64%。由于患者数量较少，T2的数据应谨慎评估。接受AF治疗的患者黏膜反应更严重，但无严重晚期反应。
AF显著提高了T1声门癌的局部控制率。
