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术后口腔癌患者螺旋断层放疗的临床疗效、毒性和失败模式。

Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients.

机构信息

Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan.

出版信息

Onco Targets Ther. 2014 Mar 10;7:405-14. doi: 10.2147/OTT.S59998. eCollection 2014.

Abstract

BACKGROUND

The outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited.

MATERIALS AND METHODS

Between November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled.

RESULTS

The 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, mucositis, and dysphagia were 11%, 34%, and 13%, respectively. No grade 3 xerostomia was noted. Grade 2 xerostomia was 33% at month 6 and declined to 0 at month 48. A rate of 56% of grade 2 trismus at month 6 was noted, and declined to around 30% after 2 years. No grade 3 trismus was noted after 2 years.

CONCLUSION

HT as a postoperative modality provided satisfying results, especially for xerostomia and trismus, and was impressive in high- and intermediate-risk OCC patients receiving postoperative HT.

摘要

背景

接受螺旋断层放疗(HT)的术后高危和中危口腔癌(OCC)患者的治疗结果仍有限。

材料与方法

2006 年 11 月至 2012 年 11 月,共纳入 53 例接受 HT 治疗的术后高危和中危 OCC 患者。

结果

4 年局部区域、局部和区域控制率分别为 66%、76.4%和 94.3%。舌和颊黏膜癌的 4 年局部区域控制率分别为 88.3%和 37.1%(P=0.012)。11 例(20.8%)患者出现局部区域复发。53 例患者中,原发部位有 6 例(11.3%)发生场内失败,区域淋巴结区有 3 例(5.7%)发生场内失败。未发现边缘失败。53 例中有 2 例(3.8%)发生场外失败。3 级皮炎、黏膜炎和吞咽困难的发生率分别为 11%、34%和 13%。未观察到 3 级口干。6 个月时 2 级口干发生率为 33%,48 个月时降至 0。6 个月时 56%的患者出现 2 级牙关紧闭,2 年后降至 30%左右。2 年后未观察到 3 级牙关紧闭。

结论

HT 作为一种术后治疗方法提供了令人满意的结果,特别是对口干和牙关紧闭的影响,对于接受术后 HT 的高危和中危 OCC 患者效果显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56d/3956740/386502074998/ott-7-405Fig1.jpg

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