单纯放疗或放化疗中每周平均辐射剂量对头颈部癌症的影响。
Impact of average weekly dose of radiation during radiotherapy alone or chemoradiotherapy in head and neck cancer.
机构信息
Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
出版信息
Head Neck. 2011 Nov;33(11):1551-6. doi: 10.1002/hed.21634. Epub 2010 Dec 9.
BACKGROUND
Altered fractionated radiotherapy (RT) has been shown to improve locoregional control (LRC) and overall survival (OS) in squamous cell cancer of the head and neck (SCCHN). We investigated patient outcomes using a new parameter: the average weekly dose (AWD).
METHODS
The medical records of 601 patients who received definitive RT for SCCHN were reviewed. AWD was calculated by dividing the total dose in Gray (Gy) by overall treatment time in weeks, and assessed for predictive value.
RESULTS
Various standard RT fractionation schedules were used. An AWD >10.0 Gy was associated with improved LRC at 2 years for patients treated with RT alone (80.9% vs 60.9%; p = .006), but not for those treated with concurrent chemoradiation (75.3% vs 77.3%; p = .77). Nonsignificant increases in late dysphagia were seen with AWD >10.0 Gy.
CONCLUSION
An AWD of >10 Gy was found to be beneficial for RT alone regimens but not chemoradiotherapy regimens.
背景
改变分割放疗（RT）已被证明可以提高头颈部鳞状细胞癌（SCCHN）的局部区域控制（LRC）和总生存率（OS）。我们使用一个新的参数：平均每周剂量（AWD）来研究患者的预后。
方法
回顾了 601 例接受 SCCHN 根治性 RT 的患者的病历。通过将总剂量（Gy）除以总治疗时间（周）来计算 AWD，并评估其预测价值。
结果
使用了各种标准的 RT 分割方案。对于仅接受 RT 治疗的患者，AWD > 10.0 Gy 与 2 年时的 LRC 改善相关（80.9% vs 60.9%；p =.006），但与同期放化疗治疗的患者无关（75.3% vs 77.3%；p =.77）。AWD > 10.0 Gy 与晚期吞咽困难的增加无关。
结论
发现 AWD > 10 Gy 对单纯 RT 方案有益，但对放化疗方案无益。
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