Gamez Mauricio E, Halyard Michele Y, Hinni Michael L, Hayden Richard E, Nagel Thomas H, Vargas Carlos E, Wong William W, Curtis Kelly K, Zarka Matthew A, Ma Daniel, Patel Samir H
1 Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona.
2 Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona.
Ann Otol Rhinol Laryngol. 2017 Mar;126(3):185-191. doi: 10.1177/0003489416681580. Epub 2017 Jan 5.
To report the outcomes of patients with favorable risk oropharyngeal cancer that underwent adjuvant radiation therapy with omission of the primary site from the clinical target volume (CTV).
MATERIAL/METHODS: A retrospective study of 40 patients treated with transoral surgery (TOS) followed by neck only radiation using intensity modulated radiation therapy (IMRT) with exclusion of the primary site. For all patients, a CTV of the primary surgical bed was contoured to obtain the estimated incidental dose to the primary site.
Median follow-up was 51 months (range, 13-155 months). The median radiation therapy (RT) dose to the neck was 6000 cGy (range, 5400-6400 cGy). The mean incidental dose to the primary tonsillar site was 4320 cGy (SD ± 480 cGy) and to the primary base of tongue site was 4060 cGy (SD ± 420 cGy). There were no local failures and only 1 regional failure, resulting in 97.5% locoregional control rate at 4 years. Two patients developed distant metastases, without evidence of locoregional recurrence, for a 4-year overall survival rate of 97%.
Our analysis suggests that mucosal sparing RT after TOS in favorable risk oropharyngeal cancer patients may provide comparable oncologic and improved functional outcomes compared to conventional treatment in selected patients.
报告风险较低的口咽癌患者接受辅助放疗且临床靶区（CTV）未包括原发部位的治疗结果。
材料/方法：对40例经口手术（TOS）治疗后仅对颈部进行调强放射治疗（IMRT）且未包括原发部位的患者进行回顾性研究。对所有患者，勾画原发手术床的CTV以获得原发部位的估计附带剂量。
中位随访时间为51个月（范围13 - 155个月）。颈部的中位放射治疗（RT）剂量为6000 cGy（范围5400 - 6400 cGy）。原发扁桃体部位的平均附带剂量为4320 cGy（标准差±480 cGy），原发舌根部位的平均附带剂量为4060 cGy（标准差±420 cGy）。无局部复发，仅1例区域复发，4年局部区域控制率为97.5%。2例患者发生远处转移，无局部区域复发证据，4年总生存率为97%。
我们的分析表明，对于风险较低的口咽癌患者，经口手术后进行黏膜保留放疗与部分患者的传统治疗相比，可能具有相当的肿瘤学效果并改善功能结局。
