对身体状况不宜接受常规治疗的头颈部癌症患者进行立体定向体部放射治疗。
Stereotactic body radiotherapy for medically unfit patients with cancers to the head and neck.
作者信息
Al-Assaf Hossam, Erler Darby, Karam Irene, Lee Justin W, Higgins Kevin, Enepekides Danny, Zhang Liying, Eskander Antoine, Poon Ian
机构信息
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2020 Aug;42(8):2050-2057. doi: 10.1002/hed.26138. Epub 2020 Mar 21.
BACKGROUND
A single institutional experience of stereotactic body radiation therapy (SBRT) to medically unfit patients with unresectable head and neck cancers (HNCs).
METHODS
A retrospective review of HNC patients undergoing SBRT was undertaken from 2011 to 2016 for fractionation ranges between 35 and 50 Gy in 4 to 6 fractions.
RESULTS
One hundred and fourteen patients with 117 SBRT courses were included with mean follow-up of 10.5 months. The cohort consisted of previously untreated primary HNC (n = 48), recurrent never irradiated HNC (n = 19), oligometastatic (n = 17) non-HNC primaries and previously irradiated HNC (n = 33). Local control (LC) at 12 months and median progression free survival was 85.8%, 78.2%, 85%, 78.9% (P = .86) and 23.7, 14.8, 10.5 and 7.8 months (P = .04) respectively. Only one patient had an acute grade 4 toxicity, two patients had grade 4 late toxicities.
CONCLUSIONS
HNC SBRT is an effective treatment for frail patients where longer LC is relevant but are unable to tolerate protracted radiation schedules.
背景
针对身体状况不佳的不可切除头颈癌（HNC）患者进行立体定向体部放射治疗（SBRT）的单机构经验。
方法
对2011年至2016年期间接受SBRT治疗的HNC患者进行回顾性研究，分次剂量范围为35至50 Gy，分4至6次照射。
结果
纳入114例患者，共进行117次SBRT疗程，平均随访10.5个月。该队列包括未经治疗的原发性HNC（n = 48）、复发且从未接受过照射的HNC（n = 19）、寡转移（n = 17）非HNC原发性肿瘤以及既往接受过照射的HNC（n = 33）。12个月时的局部控制率（LC）和无进展生存期（PFS）中位数分别为85.8%、78.2%、85%、78.9%（P = 0.86）和23.7、14.8、10.5和7.8个月（P = 0.04）。仅1例患者出现急性4级毒性反应，2例患者出现4级晚期毒性反应。
结论
对于身体虚弱但局部控制时间较长且无法耐受长时间放疗方案的患者，HNC的SBRT是一种有效的治疗方法。
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