Hsieh Chen-Hsi, Shueng Pei-Wei, Wang Li-Ying, Huang Yu-Chuen, Liao Li-Jen, Lo Wu-Chia, Lin Yu-Chin, Wu Le-Jung, Tien Hui-Ju
Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.
Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
BMC Cancer. 2016 Feb 23;16:139. doi: 10.1186/s12885-016-2165-9.
We compared the outcome of patients who received non-image-guided intensity-modulated radiotherapy (IMRT) with those who received helical tomotherapy (HT), a daily image-guided radiotherapy (IGRT), after surgery for oral cavity cancer (OCC).
During the period November 2006 to December 2013, a total of 152 postoperative OCC patients underwent either IMRT (n = 79) or daily IGRT (n = 73) 4 to 6 weeks after surgery. Patients in the IMRT group received 6 MV photon beams to 7 fields and those in the IGRT group received daily fractions of 1.8 or 2 Gy on five consecutive days.
Patients who received daily IGRT had higher 5-year overall survival than those who received IMRT (87% versus 48%, p = 0.015). The local progression-free survival rate was also higher in patients who received IGRT (85% versus 58%, p = 0.006). More patients in the IGRT group completed the package of overall treatment time in ≤ 13 weeks and completed their course of radiation therapy in ≤ 8 weeks than patients in the IMRT group (89% versus 68%, p = 0.002; 84% versus 58%, p = 0.001), respectively. The rate of local failure in the primary tumor area was 24.0 % in the IMRT group and 6.8% in the IGRT group. Among patients with primary local failure, the marginal failure rate was 52.6% in the IMRT group and 0 % in the IGRT group.
For patients with locally advanced OCC, postoperative IGRT results in better overall survival, better local progression-free survival, less marginal failure and shorter overall treatment time than postoperative non-image-guided IMRT.
我们比较了接受非图像引导调强放疗（IMRT）的口腔癌（OCC）患者与接受螺旋断层放疗（HT，一种每日图像引导放疗[IGRT]）的患者术后的治疗结果。
在2006年11月至2013年12月期间，共有152例OCC术后患者在术后4至6周接受了IMRT（n = 79）或每日IGRT（n = 73）。IMRT组患者接受6兆伏光子束照射7个野，IGRT组患者连续5天每天接受1.8或2戈瑞的分次照射。
接受每日IGRT的患者5年总生存率高于接受IMRT的患者（87%对48%，p = 0.015）。接受IGRT的患者局部无进展生存率也更高（85%对58%，p = 0.006）。与IMRT组患者相比，IGRT组更多患者在≤13周内完成了整个治疗时间套餐，且在≤8周内完成了放疗疗程（分别为89%对68%，p = 0.002；84%对58%，p = 0.001）。IMRT组原发肿瘤区域的局部失败率为24.0%，IGRT组为6.8%。在原发局部失败的患者中，IMRT组的边缘失败率为52.6%，IGRT组为0%。
对于局部晚期OCC患者，术后IGRT比术后非图像引导IMRT能带来更好的总生存率、更好的局部无进展生存率、更少的边缘失败和更短的总治疗时间。
