头颈部癌症术后放射治疗的错失和近错失：在 CT 模拟时代比较 IMRT 和非-IMRT 技术。
Misses and near-misses after postoperative radiation therapy for head and neck cancer: Comparison of IMRT and non-IMRT techniques in the CT-simulation era.
机构信息
Department of Radiation Oncology, Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
出版信息
Head Neck. 2010 Nov;32(11):1452-9. doi: 10.1002/hed.21343.
BACKGROUND
The purpose of this study was to compare the patterns of failure focusing on the distribution of local-regional recurrence among patients treated postoperatively with conventional radiotherapy (RT) and intensity-modulated radiotherapy (IMRT) for head and neck cancer.
METHODS
The records of 130 patients treated by surgery and postoperative radiation therapy for squamous cell carcinoma of the head and neck were reviewed. Seventy-eight patients (60%) were treated using conventional RT and 52 patients (40%) were treated using IMRT.
RESULTS
The 3-year estimates of local-regional control were 70% and 73% among patients treated by conventional RT and IMRT, respectively (p = .33). Among the local-regional recurrences in the IMRT group, 9 were in-field recurrences occurring within the physician-designated clinical target volume (CTV), and 4 were marginal recurrences involving the contralateral neck adjacent to the spared parotid gland (3 patients) and the retropharyngeal/retrostyloid lymph node region (1 patient).
CONCLUSION
Our study showed that conventional RT and IMRT result in similar rates of local-regional control. The implications for CTV design are discussed herein.
背景
本研究旨在比较术后接受常规放疗（RT）和调强放疗（IMRT）治疗的头颈部癌症患者的失败模式，重点关注局部区域复发的分布。
方法
回顾了 130 例接受手术和术后放疗的头颈部鳞状细胞癌患者的记录。78 例（60%）患者接受常规 RT 治疗，52 例（40%）患者接受 IMRT 治疗。
结果
接受常规 RT 和 IMRT 治疗的患者 3 年局部区域控制率分别为 70%和 73%（p =.33）。在 IMRT 组的局部区域复发中，9 例为医生指定的临床靶区（CTV）内的场内复发，4 例为边缘复发，涉及对侧颈部毗邻保留的腮腺（3 例）和咽后/茎突后淋巴结区域（1 例）。
结论
我们的研究表明，常规 RT 和 IMRT 导致相似的局部区域控制率。本文讨论了 CTV 设计的意义。
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