Yamazaki Hideya, Demizu Yusuke, Okimoto Tomoaki, Ogita Mikio, Himei Kengo, Nakamura Satoaki, Suzuki Gen, Yoshida Ken, Kotsuma Tadayuki, Yoshioka Yasuo
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
CyberKnife Center, Soseikai General Hospital, Kyoto, Japan.
Anticancer Res. 2016 Oct;36(10):5507-5514. doi: 10.21873/anticanres.11132.
To compare survival outcomes for charged particle radiotherapy (CP) and stereotactic body radiotherapy using CyberKnife (CK) in patients who had undergone re-irradiation for head and neck cancers.
We conducted a retrospective multi-institutional matched-cohort analysis on 25 patients treated with CP and 25 matched patients treated with CK according to three prognostic factors (nasopharyngeal cancer or not, interval between initial radiotherapy and re-irradiation, and planning target volume).
CP was used more often to treat non-squamous cell cancer ((non-SCC): 52% vs. 0%) with a higher prescribed dose (median=57.6 Gy(RBE)/16 fractions) than CK (32 Gy/5 fractions). The local control rate (LC) for patients treated with CP was 71.2% at 1 year and that for patients treated with CK was 63.8% (p=0.24). The 1-year overall survival (OS) rates were 67.1% for CP and 36.3% for CK (p=0.0002), respectively. Non-SCC patients showed better OS rates at 1 year than SCC patients. In the SCC sub-group analysis, the 1-year LC, OS rates were 65%, 58.3% in the CP group and 64%, 36.3% in the CK group (p=0.81, p=0.02), respectively. A total of 16 patients (32%) experienced grade 3 or worse toxicities (24% in CK and 40% in CP, p=0.36), including six grade 5 toxicities.
CP produced higher survival rates than CK, treated more non-SCC patients and used a higher prescribed dose. On the other hand, severe toxicities occurred in both groups, which, however, require further investigation.
比较对头颈部癌进行再照射的患者接受带电粒子放疗（CP）和使用射波刀（CK）进行立体定向体部放疗后的生存结果。
我们根据三个预后因素（是否为鼻咽癌、初始放疗与再照射之间的间隔以及计划靶体积），对25例接受CP治疗的患者和25例匹配的接受CK治疗的患者进行了一项回顾性多机构匹配队列分析。
CP更常用于治疗非鳞状细胞癌（非SCC：52%对0%），其处方剂量（中位数=57.6 Gy（相对生物效应）/16次分割）高于CK（32 Gy/5次分割）。接受CP治疗的患者1年局部控制率（LC）为71.2%，接受CK治疗的患者为63.8%（p=0.24）。CP和CK的1年总生存率（OS）分别为67.1%和36.3%（p=0.0002）。非SCC患者1年的OS率高于SCC患者。在SCC亚组分析中，CP组的1年LC、OS率分别为65%、58.3%，CK组为64%、36.3%（p=0.81，p=0.02）。共有16例患者（32%）出现3级或更严重的毒性反应（CK组为24%，CP组为40%，p=0.36），包括6例5级毒性反应。
CP产生的生存率高于CK，治疗的非SCC患者更多，且使用的处方剂量更高。另一方面，两组均出现了严重毒性反应，不过这需要进一步研究。
