接受有或无自适应重新计划的调强放射治疗的头颈癌患者的临床结局
Clinical outcomes among patients with head and neck cancer treated by intensity-modulated radiotherapy with and without adaptive replanning.
作者信息
Chen Allen M, Daly Megan E, Cui Jing, Mathai Mathew, Benedict Stanley, Purdy James A
机构信息
Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, California.
出版信息
Head Neck. 2014 Nov;36(11):1541-6. doi: 10.1002/hed.23477. Epub 2014 Jan 22.
BACKGROUND
The purpose of this study was to determine the effect of adaptive replanning on clinical outcome among patients treated by intensity-modulated radiotherapy (IMRT) for head and neck cancer.
METHODS
Three hundred seventeen patients underwent IMRT with daily image-guidance for newly diagnosed squamous cell carcinoma of the head and neck to a median dose of 66 Gy (range, 60-74 Gy). Of these 317 patients, 51 (16%) underwent adaptive radiotherapy with modification of the original IMRT midway during treatment.
RESULTS
The 2-year local-regional control was 88% for patients treated with adaptive replanning compared with 79% for patients treated without (p = .01). The median time to local-regional recurrence for the 4 patients treated by adaptive radiotherapy was 7 months (range, 3-15 months) with all failures occurring within the high-dose planning target volume (PTV).
CONCLUSION
Although the use of routine replanning is probably not necessary, our findings do suggest a significant benefit in appropriately selected patients.
背景
本研究的目的是确定自适应重新计划对头颈部癌调强放射治疗（IMRT）患者临床结局的影响。
方法
317例新诊断的头颈部鳞状细胞癌患者接受了每日图像引导的IMRT，中位剂量为66 Gy（范围60 - 74 Gy）。在这317例患者中，51例（16%）在治疗中途对原始IMRT进行了修改，接受了自适应放射治疗。
结果
接受自适应重新计划治疗的患者2年局部区域控制率为88%，未接受自适应重新计划治疗的患者为79%（p = 0.01）。接受自适应放射治疗的4例患者局部区域复发的中位时间为7个月（范围3 - 15个月），所有复发均发生在高剂量计划靶区（PTV）内。
结论
虽然可能没有必要使用常规重新计划，但我们的研究结果确实表明，在适当选择的患者中，自适应重新计划有显著益处。
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