Dahlke Sören, Steinmann Diana, Christiansen Hans, Durisin Martin, Eckardt Andre, Wegener Gerd, Bremer Michael, Meyer Andreas
Department of Radiation Oncology, Medical School Hannover, Hannover, Germany
Department of Radiation Oncology, Medical School Hannover, Hannover, Germany.
In Vivo. 2017 Sep-Oct;31(5):949-955. doi: 10.21873/invivo.11152.
To evaluate treatment-related factors such as overall treatment time (OTT) and radiation treatment time (RTT) in head-and-neck cancer.
A total of 216 patients with locoregionally advanced inoperable head and neck cancer were treated with definitive radio(chemo)therapy. Mean follow-up was 37 months.
Median time from diagnosis to start of radiotherapy (total waiting time) was 34 days, and comprised of referral waiting time and time for preparatory work. Median RTT was 40 days, and median OTT was 91 days. At 6, 12 and 24 months local recurrence-free survival (LRFS) was 75%, 65% and 60%; metastasis-free survival (MFS) was 84%, 77% and 70%; overall survival (OS) was 72%, 58% and 40%. Tumor stage, boost and chemotherapy were significant for OS, waiting time for preparatory work and RTT were significant for MFS, and referral waiting time and total radiotherapy dose for LRFS.
RTT ≤40 days was a prognostic factor for better MFS. Prolonged waiting time had a converse effect for radiotherapy with better outcome on MFS and LRFS.
评估头颈部癌的总体治疗时间（OTT）和放射治疗时间（RTT）等与治疗相关的因素。
共有216例局部区域晚期不可手术切除的头颈部癌患者接受了根治性放（化）疗。平均随访时间为37个月。
从诊断到开始放疗的中位时间（总等待时间）为34天，包括转诊等待时间和准备工作时间。中位RTT为40天，中位OTT为91天。在6个月、12个月和24个月时，局部无复发生存率（LRFS）分别为75%、65%和60%；无转移生存率（MFS）分别为84%、77%和70%；总生存率（OS）分别为72%、58%和40%。肿瘤分期、增敏放疗和化疗对OS有显著影响，准备工作等待时间和RTT对MFS有显著影响，转诊等待时间和总放疗剂量对LRFS有显著影响。
RTT≤40天是MFS较好的一个预后因素。等待时间延长对放疗有相反的影响，对MFS和LRFS有更好的结果。
