Istituto Clinico Humanitas IRCCS, Radiation Oncology Dept, Milan (Rozzano), Italy.
Radiat Oncol. 2010 Oct 15;5:93. doi: 10.1186/1748-717X-5-93.
To report about early clinical experience in radiation treatment of head and neck cancer of different sites and histology by volumetric modulated arcs with the RapidArc technology.
During 2009, 45 patients were treated at Istituto Clinico Humanitas with RapidArc (28 males and 17 females, median age 65 years). Of these, 78% received concomitant chemotherapy. Thirty-six patients were treated as exclusive curative intent (group A), three as postoperative curative intent (group B) and six with sinonasal tumours (group C). Dose prescription was at Planning Target Volumes (PTV) with simultaneous integrated boost: 54.45 Gy and 69.96 Gy in 33 fractions (group A); 54.45 Gy and 66 Gy in 33 fractions (group B) and 55 Gy in 25 fractions (group C).
Concerning planning optimization strategies and constraints, as per PTV coverage, for all groups, D98% > 95% and V95% > 99%. As regards organs at risk, all planning objectives were respected, and this was correlated with observed acute toxicity rates. Only 28% of patients experienced G3 mucositis, 14% G3 dermitis 44% had G2 dysphagia. Nobody required feeding tubes to be placed during treatment. Acute toxicity is also related to chemotherapy. Two patients interrupted the course of radiotherapy because of a quick worsening of general clinical condition.
These preliminary results stated that volumetric modulated arc therapy in locally advanced head and neck cancers is feasible and effective, with acceptable toxicities.
报告使用容积旋转调强弧形治疗技术（RapidArc）治疗不同部位和组织学类型头颈部肿瘤的早期临床经验。
2009 年，共有 45 例患者在 Istituto Clinico Humanitas 接受 RapidArc 治疗（28 例男性，17 例女性，中位年龄 65 岁）。其中 78%的患者接受了同期化疗。36 例患者为根治性治疗（A 组），3 例为术后根治性治疗（B 组），6 例为鼻腔鼻窦肿瘤（C 组）。计划靶区（PTV）处方剂量为同步推量：A 组 33 次 54.45Gy 和 69.96Gy；B 组 33 次 54.45Gy 和 66Gy；C 组 25 次 55Gy。
在计划优化策略和限制方面，对于所有组，PTV 覆盖的 D98%>95%，V95%>99%。对于危及器官，所有计划目标均得到了遵守，这与观察到的急性毒性发生率相关。仅有 28%的患者出现 3 级黏膜炎，14%出现 3 级皮炎，44%出现 2 级吞咽困难。治疗过程中无人需要放置饲管。急性毒性也与化疗有关。由于一般临床状况迅速恶化，有 2 例患者中断了放疗。
这些初步结果表明，容积旋转调强弧形治疗局部晚期头颈部肿瘤是可行和有效的，具有可接受的毒性。
