Department of Human Oncology, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Surgery, Division of Otolaryngology and Head and Neck Surgery, Carbone Comprehensive Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Head Neck. 2020 Aug;42(8):1874-1881. doi: 10.1002/hed.26098. Epub 2020 Feb 14.
To evaluate disease control, toxicities, and dose to dysphagia/aspiration risk structures (DARS) using a direct gross tumor volume (GTV ) to planning target volume expansion (dPTV ) for patients with squamous cell carcinoma of the larynx (LSCC).
A retrospective review was performed on patients with LSCC treated between 2003 and 2018. Clinical outcomes, toxicities, and dosimetric data were analyzed.
Seventy-three patients were identified. Overall survival at 5-years was 57.8%. Five-year local and regional control was 79.8% and 88.2%, respectively. Distant metastatic-only failure was 2.7%. Eighty percent of failures were 95% contained within the dPTV . Mean dose and the volume of DARS receiving 70 Gy was significantly lower for dPTV compared to a consensus-defined PTV .
Judicious reduction in high-dose target volumes can preserve high tumor control rates while reducing dose to normal surrounding structures underscoring the potential benefit of this approach in enabling local therapy intensification to improve locoregional control.
评估使用直接大体肿瘤体积（GTV）至计划靶区外扩（dPTV）的方法治疗喉鳞状细胞癌（LSCC）患者的疾病控制、毒性和吞咽/吸入风险结构（DARS）剂量。
对 2003 年至 2018 年间治疗的 LSCC 患者进行回顾性研究。分析临床结果、毒性和剂量学数据。
共确定了 73 例患者。5 年总生存率为 57.8%。5 年局部控制率和区域控制率分别为 79.8%和 88.2%。远处转移失败仅为 2.7%。80%的失败病例 95%的体积包含在 dPTV 内。与共识定义的 PTV 相比，dPTV 的平均剂量和 DARS 体积接受 70Gy 的剂量明显更低。
明智地减少高剂量靶区体积可以在降低正常周围结构剂量的同时保持高肿瘤控制率，这突显了这种方法的潜在益处，即能够加强局部治疗以提高局部区域控制率。
