Department of Radiation Oncology, Peking University Third Hospital , Beijing, China.
Cancer Biol Ther. 2020 Jul 2;21(7):623-628. doi: 10.1080/15384047.2020.1743149. Epub 2020 Apr 16.
Retrospective analysis of the long-term clinical outcome and acute toxicity of the primary malignant tumor of cervical spine receiving CBCT image-guided VMAT.
Thirty patients with primary malignant tumor of the cervical spine included in our center, from December 2013 to January 2016, 28 patients were retrospectively studied. The prescription dosage 95% PTV volume dose was 44 Gy, 2.0 Gy/fraction, and a total of 22 times. The median PGTV synchronized volume dose was 60 Gy (45-62.1 Gy), median 2.5 Gy (2-2.7 Gy)/fraction. In volumetric modulated, two arc volumetric modulated arc therapy (VMAT) was used, with spinal cord dosage D< 45 Gy. Early response rate and acute toxicities were analyzed.
The follow-up duration was 6-76 months (median 53 months). At the end of follow-up of June 1, 2019, 78.6% (22/28) patients were still alive. 3 and 5-y local control rates were 67.3% and 56.5% while 3 and 5-y OS were both 78.6% in the whole group of patients, respectively. Fourteen patients with chordoma 5-y local control rates and OS were 57.1% and 85.7%, respectively. Nine patients with giant-cell tumor of bone had a 5-y local control rate and OS were 77.8% and 85.7%, respectively. The response rate for moderate pain or above was 80% (8/10). Eleven patients (39.3%) suffered from grade 1 acute skin toxicity. Twenty-four patients (85.7%) had grade 1/2 mucositis. No radiation-induced spinal cord injury was found.
The image-guided VMAT for primary malignant tumor of the cervical spine provided a satisfactory long-term local control rate.
回顾性分析接受 CBCT 图像引导 VMAT 的原发性颈椎恶性肿瘤的长期临床结果和急性毒性。
纳入我中心 2013 年 12 月至 2016 年 1 月的 30 例原发性颈椎恶性肿瘤患者，其中 28 例进行回顾性研究。处方剂量 95%PTV 体积剂量为 44Gy，2.0Gy/次，共 22 次。中位 PGTV 同步体积剂量为 60Gy（45-62.1Gy），中位 2.5Gy/次。在容积调制中，采用双弧容积调制弧形治疗（VMAT），脊髓剂量 D<45Gy。分析早期反应率和急性毒性。
随访时间为 6-76 个月（中位随访时间 53 个月）。截至 2019 年 6 月 1 日随访结束时，28 例患者中仍有 78.6%（22/28）存活。全组患者 3 年和 5 年局部控制率分别为 67.3%和 56.5%，3 年和 5 年 OS 率均为 78.6%。14 例脊索瘤患者 5 年局部控制率和 OS 率分别为 57.1%和 85.7%。9 例骨巨细胞瘤患者 5 年局部控制率和 OS 率分别为 77.8%和 85.7%。中重度疼痛缓解率为 80%（8/10）。11 例（39.3%）患者发生 1 级急性皮肤毒性。24 例（85.7%）患者发生 1/2 级黏膜炎。未发现放射性脊髓损伤。
原发性颈椎恶性肿瘤的图像引导 VMAT 提供了满意的长期局部控制率。
