Iatì Giuseppe, Parisi Silvana, Santacaterina Anna, Pontoriero Antonio, Cacciola Alberto, Brogna Anna, Platania Angelo, Palazzolo Carmela, Cambareri Domenico, Davì Valerio, Napoli Ilenia, Lillo Sara, Severo Cesare, Tamburella Consuelo, Vadalà Roberta, Delia Pietro, Pergolizzi Stefano
Unit of Radiation Oncology - University Hospital "G. Martino", Via Consolare Valeria, 1 - 98125 Messina, Italy.
Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy.
Rep Pract Oncol Radiother. 2020 May-Jun;25(3):399-404. doi: 10.1016/j.rpor.2020.04.006. Epub 2020 Apr 13.
To evaluate clinical outcome in locally-advanced stage IV (M0) head and neck cancer patients treated using intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) in daily clinical practice.
Despite SIB-IMRT has been reported as a feasible and effective advanced head and neck cancer treatment, there are few data about its concurrent use with systemic therapies.
We reviewed 41 staged IV (M0) head and neck cancer patients treated in two radiotherapy units in the city of Messina (Italy) during the last six years, using intensity modulated techniques-SIB. 22/41 patients had concomitant chemotherapy or cetuximab. Acute and late toxicities, objective response (OR) rate, local control (LC) and overall survival (OS) have been evaluated.
37/41 patients received the planned doses of radiotherapy, 2 patients died during the therapy. The major acute regional toxicities were skin reaction and mucositis. A case of mandibular osteoradionecrosis was recorded. At completion of treatment, OR was evaluated in 38 patients: 32/38 patients (84.2%) had complete (55.3%) and partial (28.9%) response. The 1- and 5-year LC rates were 73.4% and 69.73%, respectively. The 1-, 3-, and 5-year OS rates were 85.93%, 51.49% and 44.14%, respectively. No statistically significant differences in outcomes have been observed in patients treated with radiotherapy alone vs. irradiation concomitant to chemo/biotherapy. The median OS was 45 months.
SIB-IMRT is safeand can be used with concomitant chemotherapy/biotherapy in real-life daily clinical practice. SIB-IMRT alone is a valid alternative in patients unfit for systemic therapies.
评估在日常临床实践中，采用调强放疗（IMRT）联合同步整合加量（SIB）治疗局部晚期IV期（M0）头颈癌患者的临床疗效。
尽管SIB-IMRT已被报道为一种可行且有效的晚期头颈癌治疗方法，但关于其与全身治疗同时使用的数据却很少。
我们回顾了过去六年在意大利墨西拿市两个放疗单位使用调强技术-SIB治疗的41例分期为IV期（M0）的头颈癌患者。41例患者中有22例同时接受了化疗或西妥昔单抗治疗。评估了急性和晚期毒性、客观缓解（OR）率、局部控制（LC）和总生存期（OS）。
41例患者中有37例接受了计划的放疗剂量，2例患者在治疗期间死亡。主要的急性局部毒性是皮肤反应和粘膜炎。记录到1例下颌骨放射性骨坏死病例。治疗结束时，对38例患者进行了OR评估：38例患者中有32例（84.2%）获得了完全缓解（55.3%）和部分缓解（28.9%）。1年和5年的LC率分别为73.4%和69.73%。1年、3年和5年的OS率分别为85.93%、51.49%和44.14%。在单纯放疗患者与放化疗/生物治疗联合放疗患者中，未观察到疗效上的统计学显著差异。中位OS为45个月。
SIB-IMRT是安全的，并且可以在现实生活中的日常临床实践中与化疗/生物治疗联合使用。对于不适合全身治疗的患者，单独使用SIB-IMRT是一种有效的替代方案。
