Department of Radiation Oncology, Stanford University, Stanford, CA, USA.
Radiat Oncol. 2011 Jun 15;6:72. doi: 10.1186/1748-717X-6-72.
The purpose of this study is to review our experience with the use of IORT for patients with advanced cervical metastasis.
Between August 1982 and July 2007, 231 patients underwent neck dissections as part of initial therapy or as salvage treatment for advanced cervical node metastases resulting from head and neck malignancies. IORT was administered as a single fraction to a dose of 15 Gy or 20 Gy in most pts. The majority was treated with 5 MeV electrons (112 pts, 50.5%).
1, 3, and 5 years overall survival (OS) after surgery + IORT was 58%, 34%, and 26%, respectively. Recurrence-free survival (RFS) at 1, 3, and 5 years was 66%, 55%, and 49%, respectively. Disease recurrence was documented in 83 (42.8%) pts. The majority of recurrences were regional (38 pts), as compared to local recurrence in 20 pts and distant failures in 25 pts. There were no perioperative fatalities.
IORT results in effective local disease control at acceptable levels of toxicity. Our results support the initiation of a phase III trial comparing outcomes for patients with cervical metastasis treated with or without IORT.
本研究旨在回顾我们使用术中放疗（IORT）治疗晚期颈转移患者的经验。
1982 年 8 月至 2007 年 7 月期间，231 例患者接受了颈部切除术，作为头颈部恶性肿瘤引起的晚期颈部淋巴结转移的初始治疗或挽救性治疗的一部分。大多数患者接受了单次分割剂量为 15Gy 或 20Gy 的 IORT（112 例，50.5%），采用 5MeV 电子束进行治疗。
手术后+IORT 的 1、3 和 5 年总生存率（OS）分别为 58%、34%和 26%。1、3 和 5 年无复发生存率（RFS）分别为 66%、55%和 49%。83 例（42.8%）患者记录到疾病复发。大多数复发为区域性（38 例），20 例为局部复发，25 例为远处失败。无围手术期死亡。
IORT 可有效控制局部疾病，毒性可接受。我们的结果支持启动一项 III 期试验，比较接受或不接受 IORT 治疗的颈转移患者的结局。
