调强放疗治疗喉和声门下区局部晚期癌症。
Intensity-modulated radiotherapy for locally advanced cancers of the larynx and hypopharynx.
机构信息
Department of Radiation Oncology, Stanford University Medical Center, Stanford, California, USA.
出版信息
Head Neck. 2011 Jan;33(1):103-11. doi: 10.1002/hed.21406.
BACKGROUND
Limited data evaluate intensity-modulated radiotherapy (IMRT) for cancers of the hypopharynx and larynx. We report clinical outcomes and failure patterns for these patients.
METHODS
Between September 2001 and December 2007, 42 patients with squamous cell carcinoma (SCC) of the hypopharynx (n = 23) and larynx (n = 19) underwent IMRT, 11 postoperatively and 31 definitively. Thirty-six received systemic therapy. Median follow-up was 30 months among surviving patients.
RESULTS
Three local failures occurred within the high-dose region and 3 occurred in regional nodes. Seven patients developed distant metastasis as the initial failure. Three-year actuarial estimates of locoregional control, freedom from distant metastasis, and overall survival rates were, respectively, 80%, 72%, and 46%.
CONCLUSIONS
IMRT provides good locoregional control for SCC of the hypopharynx and larynx compared with historical controls. Locoregional relapses occurred in the high-dose volumes, suggesting adequate target volume delineation. Hypopharyngeal tumors, which fare worse than laryngeal tumors, warrant investigation of more aggressive treatment.
背景
有限的数据评估了适形调强放疗（IMRT）治疗下咽和喉的癌症。我们报告了这些患者的临床结果和失败模式。
方法
在 2001 年 9 月至 2007 年 12 月期间，42 例鳞状细胞癌（SCC）下咽（n=23）和喉（n=19）患者接受了 IMRT，其中 11 例为术后，31 例为根治性。36 例患者接受了系统治疗。在存活患者中，中位随访时间为 30 个月。
结果
3 例局部失败发生在高剂量区域，3 例发生在区域淋巴结。7 例患者最初出现远处转移。3 年局部区域控制、无远处转移和总生存率的估计分别为 80%、72%和 46%。
结论
与历史对照相比，IMRT 为下咽和喉的 SCC 提供了良好的局部区域控制。局部区域复发发生在高剂量体积内，表明靶区勾画充分。下咽肿瘤的预后比喉肿瘤差，需要进一步研究更积极的治疗方法。
Zotero 插件