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口咽癌的两步调强放射治疗:初步临床经验及临床分期验证

Two-step Intensity-modulated Radiation Therapy for Oropharyngeal Cancer: Initial Clinical Experience and Validation of Clinical Staging.

作者信息

Tatebe Hitoshi, Doi Hiroshi, Ishikawa Kazuki, Kawakami Hisato, Yokokawa Masaki, Nakamatsu Kiyoshi, Kanamori Shuichi, Shibata Toru, Kitano Mutsukazu, Nishimura Yasumasa

机构信息

Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka, Japan

Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka, Japan.

出版信息

Anticancer Res. 2018 Feb;38(2):979-986. doi: 10.21873/anticanres.12312.

Abstract

AIM

To evaluate the clinical results of two-step intensity-modulated radiation therapy (IMRT) for oropharyngeal cancer.

PATIENTS AND METHODS

Eighty patients were treated with two-step IMRT between 2002 and 2014. Whole-neck radiotherapy (44.0-50.0 Gy/22-25 fractions) was delivered by IMRT, followed by boost IMRT to the high-risk clinical target volume (total dose of 70.0 Gy/35 fractions). Forty-seven patients received concurrent chemotherapy. Immunohistochemistry for human papillomavirus type 16 (HPV/p16) was performed for 64 patients.

RESULTS

The 5-year overall survival and locoregional control rates for stage I, II, III, and IVA-B disease were 80.0%, 75.0%, 78.0%, and 64.0% and 100.0%, 75.0%, 92.0%, and 82.0%, respectively. Overall survival was significantly higher in HPV/p16-positive patients than in HPV/p16-negative patients (p=0.01). Xerostomia of grade 2 or more was noted in 10 patients.

CONCLUSION

Favourable overall survival and locoregional control rates with excellent salivary preservation were obtained using the two-step IMRT method for oropharyngeal cancer.

摘要

目的

评估口咽癌两步调强放射治疗(IMRT)的临床效果。

患者与方法

2002年至2014年间,80例患者接受了两步IMRT治疗。全颈放疗(44.0 - 50.0 Gy/22 - 25分次)采用IMRT进行,随后对高危临床靶区进行IMRT推量(总剂量70.0 Gy/35分次)。47例患者接受了同步化疗。对64例患者进行了16型人乳头瘤病毒(HPV/p16)免疫组化检测。

结果

I、II、III和IVA - B期疾病的5年总生存率和局部区域控制率分别为80.0%、75.0%、78.0%和64.0%以及100.0%、75.0%、92.0%和82.0%。HPV/p16阳性患者的总生存率显著高于HPV/p16阴性患者(p = 0.01)。10例患者出现2级或更高级别的口干。

结论

采用两步IMRT方法治疗口咽癌可获得良好的总生存率和局部区域控制率,并能很好地保留唾液。

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