Hu Kenneth Shung, Mourad Waleed Fouad, Gamez Mauricio, Safdieh Joseph, Lin Wilson, Jacobson Adam Saul, Persky Mark Stephen, Urken Mark Lawrence, Culliney Bruce, Li Zujun, Tran Theresa Nguyen, Schantz Stimson Pryor, Chadha Juskaran, Harrison Louis Benjamin
Department of Radiation Oncology, New York University Langone Medical Center, New York, New York.
Department of Radiation Oncology, Georgia Regents University, Augusta, Georgia.
Head Neck. 2017 Aug;39(8):1647-1654. doi: 10.1002/hed.24806. Epub 2017 May 5.
Unilateral radiotherapy (RT) of oropharyngeal carcinomas is accepted for patients with lateralized primary and low-volume nodal disease. Utilizing prospectively defined criteria of laterality and staging positron emission tomography (PET)/CT, we studied outcomes in patients with advanced-stage oropharyngeal cancer undergoing unilateral RT.
Thirty-seven patients with oropharyngeal tumors >1 cm from midline regardless of node status underwent unilateral RT and were followed prospectively. Patient characteristics: T1 = 11; T2 = 22; T3 = 4; N0 = 3; N1 = 9; N2a = 3; N2b = 21; and Nx = 1. Dosimetry were determined and weekly National Comprehensive Cancer Network (NCCN) distress thermometer data were collected.
At median follow-up of 32 months, 3-year locoregional control, contralateral regional failure, distant metastasis-free survival, and disease-free survival were 96%, 0%, 7%, and 93%, respectively.
Low rates of contralateral neck failure are demonstrated utilizing prospectively defined criteria for unilateral RT. The tolerances of contralateral organs are respected and patients report low to moderate levels of distress throughout treatment.
对于原发灶局限且淋巴结转移灶体积较小的口咽癌患者，单侧放射治疗（RT）已被广泛接受。利用前瞻性定义的侧别和分期正电子发射断层扫描（PET）/CT标准，我们研究了接受单侧RT的晚期口咽癌患者的治疗结果。
37例原发灶距中线>1 cm的口咽肿瘤患者，无论淋巴结状态如何，均接受单侧RT，并进行前瞻性随访。患者特征：T1 = 11例；T2 = 22例；T3 = 4例；N0 = 3例；N1 = 9例；N2a = 3例；N2b = 21例；Nx = 1例。确定剂量测定，并收集每周的美国国立综合癌症网络（NCCN）痛苦温度计数据。
中位随访32个月时，3年局部区域控制率、对侧区域失败率、无远处转移生存率和无病生存率分别为96%、0%、7%和93%。
利用前瞻性定义的单侧RT标准，对侧颈部失败率较低。对侧器官的耐受性得到尊重，患者在整个治疗过程中报告的痛苦程度为低至中度。
