Adrian Gabriel, Gebre-Medhin Maria, Kjellén Elisabeth, Wieslander Elinore, Zackrisson Björn, Nilsson Per
Department of Clinical Sciences Lund, Oncology, Skåne University Hospital, Lund University, Lund, Sweden.
Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
Head Neck. 2020 Aug;42(8):2099-2105. doi: 10.1002/hed.26142. Epub 2020 Mar 20.
A large tumor volume negatively impacts the outcome of radiation therapy (RT). Altered fractionation (AF) can improve local control (LC) compared with conventional fractionation (CF). The aim of the present study was to investigate if response to AF differs with tumor volume in oropharyngeal cancer.
Three hundred and twenty four patients with oropharyngeal cancer treated in a randomized, phase III trial comparing CF (2 Gy/d, 5 d/wk, 7 weeks, total dose 68 Gy) to AF (1.1 Gy + 2 Gy/d, 5 d/wk, 4.5 weeks, total dose 68 Gy) were analyzed.
Tumor volume had less impact on LC for patients treated with AF. There was an interaction between tumor volume and fractionation schedule (P = .039). This differential response was in favor of CF for small tumors and of AF for large tumors.
AF diminishes the importance of tumor volume for local tumor control in oropharyngeal cancer.
大肿瘤体积对放射治疗（RT）的结果产生负面影响。与常规分割（CF）相比，改变分割（AF）可改善局部控制（LC）。本研究的目的是调查口咽癌中对AF的反应是否因肿瘤体积而异。
分析了324例口咽癌患者，这些患者参加了一项随机III期试验，该试验比较了CF（2 Gy/天，5天/周，7周，总剂量68 Gy）与AF（1.1 Gy + 2 Gy/天，5天/周，4.5周，总剂量68 Gy）。
对于接受AF治疗的患者，肿瘤体积对LC的影响较小。肿瘤体积与分割方案之间存在相互作用（P = 0.039）。这种差异反应有利于小肿瘤的CF和大肿瘤的AF。
AF降低了肿瘤体积在口咽癌局部肿瘤控制中的重要性。
