Chalissery J R, Sudheeran P C, Varghese K M, Venkatesan K
Department of Radiation Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India.
Indian J Cancer. 2016 Oct-Dec;53(4):483-486. doi: 10.4103/ijc.IJC_78_17.
To assess the feasibility, tolerance and response of radical chemo irradiation using Intensity modulated Radiotherapy [IMRT] in elderly patients [age >65] with locally advanced head and neck cancer.
Patients aged 65 and above [range 65 to 84years] registered in oncology outpatient unit in our institution between December 2011 to 2014, with stage III and IV head and neck cancer were treated with radical dose of radiotherapy using IMRT and concurrent chemotherapy with cisplatin 40mg/sq.m weekly. Response evaluation and toxicity profile assessment was done 6 to 8 weeks after completion of treatment and 3 monthly thereafter with median follow up of 3 years.
Total number of patients analysed were 47. 43(91.5%) patients tolerated 66-.70Gy of radiotherapy and 4 or more cycles of weekly chemotherapy with cisplatin. First follow up evaluation at 6 to 8 weeks showed 81% patients having complete loco regional response. Grade III skin reaction and mucositis was noticed in 24% and 47% respectively. No grade III neutropenia observed. Median follow up of 3 years showed a complete local control in 53% and overall survival of 60%.
Radical chemo irradiation with IMRT in elderly patients is a feasible option. Long term local control and overall survival benefits needs to be followed up.
评估调强放疗（IMRT）用于老年（年龄>65岁）局部晚期头颈癌患者进行根治性化疗放疗的可行性、耐受性及反应。
2011年12月至2014年期间在我院肿瘤门诊登记的65岁及以上（年龄范围65至84岁）、患有III期和IV期头颈癌的患者，采用IMRT进行根治性放疗剂量，并同时每周使用顺铂40mg/平方米进行化疗。在治疗完成后6至8周进行反应评估和毒性特征评估，此后每3个月进行一次，中位随访时间为3年。
分析的患者总数为47例。43例（91.5%）患者耐受66 - 70Gy的放疗以及4个或更多周期的顺铂每周化疗。6至8周的首次随访评估显示81%的患者有完全的局部区域反应。分别有24%和47%的患者出现III级皮肤反应和粘膜炎。未观察到III级中性粒细胞减少。3年的中位随访显示局部完全控制率为53%，总生存率为60%。
老年患者采用IMRT进行根治性化疗放疗是一种可行的选择。长期的局部控制和总生存获益需要进一步随访。
