Pollard Courtney, Nguyen Theresa P, Ng Sweet Ping, Frank Steven J, Garden Adam S, Gunn Gary B, Fuller Clifton D, Beadle Beth M, Morrison William H, Shah Shah J, Wang He, Tung Sam, Wang Conjun, Ginsberg Lawrence D, Zafereo Mark E, Sturgis Erich M, Su Shirley Y, Hanna Ehab Y, Rosenthal David I, Phan Jack
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Radiation Oncology, Stanford University, Stanford, California.
Head Neck. 2017 Oct;39(10):2079-2087. doi: 10.1002/hed.24872. Epub 2017 Jul 25.
The purpose of this study was to present our experience with retropharyngeal node reirradiation using highly conformal radiotherapy (RT).
A retrospective screen of 2504 consecutively irradiated patients with head and neck malignancies between 2005 and 2015 identified 19 patients who underwent reirradiation for retropharyngeal node metastasis. Clinical and toxicity outcomes were assessed in these patients.
Thirteen patients (68%) had squamous cell carcinoma. Eleven patients (58%) received conventionally fractionated intensity-modulated radiotherapy (IMRT) or proton therapy, and 8 patients (42%) received single-fractionated or hypofractionated stereotactic RT. Fourteen patients (74%) received chemotherapy. Median follow-up was 14.7 months. The 1-year local control, locoregional control, overall survival, and progression-free survival rates were 100%, 94%, 92%, and 92%, respectively. Three patients (16%) experienced acute grade 3 toxicity and occurred in those treated with IMRT. There was no late grade ≥3 toxicity.
Retropharyngeal node reirradiation with conformal therapy is well tolerated and associated with excellent short-term disease control.
本研究的目的是介绍我们使用高剂量适形放疗（RT）对咽后淋巴结进行再照射的经验。
对2005年至2015年间连续接受放疗的2504例头颈部恶性肿瘤患者进行回顾性筛查，确定了19例因咽后淋巴结转移而接受再照射的患者。对这些患者的临床和毒性结果进行了评估。
13例患者（68%）为鳞状细胞癌。11例患者（58%）接受了常规分割调强放疗（IMRT）或质子治疗，8例患者（42%）接受了单次分割或低分割立体定向放疗。14例患者（74%）接受了化疗。中位随访时间为14.7个月。1年局部控制率、局部区域控制率、总生存率和无进展生存率分别为100%、94%、92%和92%。3例患者（16%）出现3级急性毒性反应，均发生在接受IMRT治疗的患者中。没有出现≥3级晚期毒性反应。
适形治疗对咽后淋巴结进行再照射耐受性良好，且与出色的短期疾病控制相关。
