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加速放疗联合推量技术(69.5Gy/5 周):局部晚期头颈部癌症治疗的一种选择。

Accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) : an alternative in the treatment of locally advanced head and neck cancer.

机构信息

Institute of Radiation Oncology, Prague, The Czech Republic.

出版信息

Strahlenther Onkol. 2011 Oct;187(10):651-5. doi: 10.1007/s00066-011-2246-2. Epub 2011 Sep 23.

Abstract

BACKGROUND AND PURPOSE

To present the feasibility and results of accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) in the treatment of locally advanced head and neck cancer.

PATIENTS AND METHODS

A total of 65 patients were treated between June 2006 and August 2009. The distribution of clinical stages was as follows: II 11%, III 23%, IV 61%, and not defined 5%.

RESULTS

The median follow-up was 30.5 months. The treatment plan was completed in 94% of patients. Patients were treated using the conformal or intensity-modulated radiotherapy (IMRT) technique. The median overall treatment time was 37 days (13-45 days). The mean radiotherapy dose was 68.4 Gy (16-74 Gy). Overall survival was 69% after 2 years. Disease-free survival was 62% after 2 years. Acute toxicity ≥ grade 3(RTOG scale) included mucositis (grade 3: 42.6%), pharynx (grade 3: 42.3%), skin (grade 3: 9.5%), larynx (grade 3: 4%), while late toxicity affected skin (grade 3: 6.25%) and salivary glands (grade 3: 3.7%).

CONCLUSION

Accelerated radiotherapy with concomitant boost technique is feasible in patients with locally advanced head and neck cancer, has an acceptable toxicity profile, and yields promising treatment results.

摘要

背景与目的

介绍局部晚期头颈部癌采用同时加量加速放疗(69.5Gy/5 周)的可行性和结果。

患者与方法

2006 年 6 月至 2009 年 8 月共治疗了 65 例患者。临床分期分布如下:Ⅱ期 11%,Ⅲ期 23%,Ⅳ期 61%,未明确 5%。

结果

中位随访时间为 30.5 个月。94%的患者完成了治疗计划。采用适形或调强放疗(IMRT)技术进行治疗。中位总治疗时间为 37 天(13-45 天)。平均放疗剂量为 68.4Gy(16-74Gy)。2 年总生存率为 69%。2 年无病生存率为 62%。≥3 级急性毒性(RTOG 分级)包括黏膜炎(3 级:42.6%)、咽(3 级:42.3%)、皮肤(3 级:9.5%)、喉(3 级:4%),晚期毒性影响皮肤(3 级:6.25%)和唾液腺(3 级:3.7%)。

结论

局部晚期头颈部癌采用同时加量加速放疗是可行的,具有可接受的毒性特征,治疗效果有前景。

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