Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Int J Radiat Oncol Biol Phys. 2013 Mar 15;85(4):941-7. doi: 10.1016/j.ijrobp.2012.08.004. Epub 2012 Sep 11.
To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT).
The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed.
The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease.
Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.
报告在德克萨斯大学 MD 安德森癌症中心接受调强放疗 (IMRT) 治疗的鳞状细胞口咽癌患者的大队列的成熟结果。
在数据库中搜索了 2000 年至 2007 年间在德克萨斯大学 MD 安德森癌症中心接受 IMRT 治疗的被诊断为口咽癌的患者。对结果数据进行了回顾性分析。
该队列包括 776 名患者。159 名患者（21%）为当前吸烟者，279 名（36%）为曾经吸烟者，337 名（43%）为从不吸烟者。T 和 N 类别和美国癌症联合委员会分期分布如下：T1/x，288 例（37%）；T2，288 例（37%）；T3，113 例（15%）；T4，87 例（11%）；N0，88 例（12%）；N1/x，140 例（18%）；N2a，101 例（13%）；N2b，269 例（35%）；N2c，122 例（16%）；N3，56 例（7%）；I 期，18 例（2%）；II 期，40 例（5%）；III 期，150 例（19%）；IV 期，568 例（74%）。71 例（10%）患者存在 IV 级淋巴结。中位随访时间为 54 个月。5 年总生存率、局部区域控制率和总无复发生存率分别为 84%、90%和 82%。7%的患者出现原发部位复发，3%的患者出现颈部复发且原发部位得到控制。我们仅发现 12 例（2%）患者在高剂量靶区外出现局部区域复发。当前吸烟者、原发肿瘤较大（T）和颈部疾病较低的患者生存率较差。
接受 IMRT 治疗的口咽癌患者疾病控制良好。局部区域复发并不常见，且多发生在高剂量区域内。通过保留腮腺，在不影响肿瘤覆盖范围的情况下，几乎所有患者都可以避免辐射损伤。
