Cho Ick Joon, Chung Woong-Ki, Lee Joon Kyoo, Lee Min-Cheol, Paek Jayeong, Kim Yong-Hyub, Jeong Jae-Uk, Yoon Mee Sun, Song Ju-Young, Nam Taek-Keun, Ahn Sung-Ja, Lee Dong Hoon, Yoon Tae Mi, Lim Sang-Chul
Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
Radiat Oncol J. 2019 Dec;37(4):271-278. doi: 10.3857/roj.2019.00283. Epub 2019 Dec 31.
To investigate the differences in treatment outcomes between two radiation techniques, intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT).
We retrospectively analyzed 160 (IMRT = 23, 3DCRT = 137) patients with stage I glottic cancer treated from January 2005 through December 2016. The IMRT was performed with TomoTherapy (16 patients), volumetric-modulated arc therapy (6 patients), and step-and-shoot technique (1 patient), respectively. The 3DCRT was performed with bilateral parallel opposing fields. The median follow-up duration was 30 months (range, 31 to 42 months) in the IMRT group and 65 months (range, 20 to 143 months) in the 3DCRT group.
The 5-year overall survival and 3-year local control rates of the 160 patients were 95.7% and 91.4%, respectively. There was no significant difference in 3-year local control rates between the IMRT and 3DCRT groups (94.4% vs. 91.0%; p = 0.587). Thirteen of 137 patients in the 3DCRT group had recurrences. In the IMRT group, one patient had a recurrence at the true vocal cord. Patients treated with IMRT had less grade 2 skin reaction than the 3DCRT group, but this had no statistical significance (4.3% vs. 21.2%; p = 0.080).
IMRT had comparable outcomes with 3DCRT, and a trend of less acute skin reaction in stage I glottic cancer patients.
探讨两种放疗技术,即调强放疗(IMRT)和三维适形放疗(3DCRT)在治疗效果上的差异。
我们回顾性分析了2005年1月至2016年12月期间接受治疗的160例I期声门癌患者(IMRT组23例,3DCRT组137例)。IMRT分别采用螺旋断层放疗(16例患者)、容积调强弧形放疗(6例患者)和静态调强放疗技术(1例患者)。3DCRT采用双侧平行相对野照射。IMRT组的中位随访时间为30个月(范围31至42个月),3DCRT组为65个月(范围20至143个月)。
160例患者的5年总生存率和3年局部控制率分别为95.7%和91.4%。IMRT组和3DCRT组的3年局部控制率无显著差异(94.4%对91.0%;p = 0.587)。3DCRT组的137例患者中有13例复发。在IMRT组中,1例患者在真声带处复发。接受IMRT治疗的患者2级皮肤反应低于3DCRT组,但无统计学意义(4.3%对21.2%;p = 0.080)。
IMRT与3DCRT的治疗效果相当,且I期声门癌患者的急性皮肤反应有减少的趋势。