头颈部恶性肿瘤立体定向放射外科治疗的长期随访

Long-term follow-up of stereotactic radiosurgery for head and neck malignancies.

作者信息

Owen Dawn, Iqbal Fawaad, Pollock Bruce E, Link Michael J, Stien Kathy, Garces Yolanda I, Brown Paul D, Foote Robert L

机构信息

Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.

出版信息

Head Neck. 2015 Nov;37(11):1557-62. doi: 10.1002/hed.23798. Epub 2014 Aug 1.

DOI:10.1002/hed.23798

PMID:24912475

Abstract

BACKGROUND

Stereotactic radiosurgery is widely applied to deliver additional dose to head and neck tumors. However, its safety and efficacy remains equivocal.

METHODS

One hundred eighty-four patients with primary head and neck cancers treated between January 1990 and August 2012 with Gamma Knife stereotactic radiosurgery were retrospectively reviewed.

RESULTS

Two hundred fifteen sites were treated with Gamma Knife stereotactic radiosurgery among 184 patients. Fifty-one percent of patients received concurrent external beam radiotherapy (EBRT), 72% had prior surgery, and 46% received chemotherapy. Most (44%) had squamous cell carcinoma and most patients (65%) were treated for recurrent disease. With a median follow-up of 17.3 months, 12-month local control was 82%. Late effects occurred in 59 patients with the most common being temporal lobe necrosis (15 patients).

CONCLUSION

Radiosurgery can provide tumor control for patients with head and neck cancers involving the skull base. Long-term follow-up is important in survivors to identify late effects.

摘要

背景

立体定向放射外科广泛应用于对头颈部肿瘤给予额外剂量照射。然而，其安全性和有效性仍不明确。

方法

回顾性分析1990年1月至2012年8月间接受伽玛刀立体定向放射外科治疗的184例原发性头颈部癌患者。

结果

184例患者中215个部位接受了伽玛刀立体定向放射外科治疗。51%的患者接受了同步外照射放疗（EBRT），72%的患者曾接受手术，46%的患者接受了化疗。大多数（44%）为鳞状细胞癌，大多数患者（65%）接受复发性疾病治疗。中位随访时间为17.3个月，12个月的局部控制率为82%。59例患者出现晚期效应，最常见的是颞叶坏死（15例）。