头颈部癌治疗后的放射性骨坏死及放射剂量测定的影响：盖伊和圣托马斯头颈癌治疗中心的经验
Osteoradionecrosis following treatment for head and neck cancer and the effect of radiotherapy dosimetry: the Guy's and St Thomas' Head and Neck Cancer Unit experience.
作者信息
De Felice Francesca, Thomas Christopher, Patel Vinod, Connor Steve, Michaelidou Andriana, Sproat Chris, Kwok Jerry, Burke Mary, Reilly Damien, McGurk Mark, Simo Ricard, Lyons Andrew, Oakley Richard, Jeannon Jean-Pierre, Lei Mary, Urbano Teresa Guerrero
机构信息
Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK; Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):28-34. doi: 10.1016/j.oooo.2016.01.007. Epub 2016 Jan 14.
OBJECTIVES
To analyze clinical features, dosimetric parameters, and outcomes of osteoradionecrosis (ORN).
STUDY DESIGN
Thirty-six patients with ORN who had been previously treated with radiotherapy (RT) were retrospectively identified between January 2009 and April 2014. ORN volumes were contoured on planning computed tomography (CT) scans. Near maximum dose (D2%), minimum dose (Dmin), mean dose (Dmean), and percentage of bone volume receiving 50 Gy (V50) were examined. Clinical and dosimetric variables were considered to compare ORN resolution versus ORN persistence.
RESULTS
Median interval time from end of RT to development of ORN was 6 months. Of the ORN cases, 61% were located in the mandible. Dmean to affected bone was 57.6 Gy, and 44% had a D2% 65 Gy or greater. Smoking was associated with ORN persistence on univariate analysis, but no factors were found to impact ORN resolution or progression on logistic regression.
CONCLUSIONS
Prevention strategies for ORN development should be prioritized. Dose-volume parameters could have a role in preventing ORN.
目的
分析放射性骨坏死（ORN）的临床特征、剂量学参数及治疗结果。
研究设计
回顾性纳入2009年1月至2014年4月间36例曾接受过放射治疗（RT）的ORN患者。在计划计算机断层扫描（CT）图像上勾勒ORN体积。检测近最大剂量（D2%）、最小剂量（Dmin）、平均剂量（Dmean）以及接受50 Gy照射的骨体积百分比（V50）。通过比较ORN愈合与ORN持续存在情况，分析临床和剂量学变量。
结果
从放疗结束至ORN发生的中位间隔时间为6个月。ORN病例中，61%位于下颌骨。患骨的Dmean为57.6 Gy，44%的患者D2%≥65 Gy。单因素分析显示吸烟与ORN持续存在相关，但逻辑回归分析未发现影响ORN愈合或进展的因素。
结论
应优先制定ORN发生的预防策略。剂量-体积参数可能对预防ORN有作用。
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