Benhmida S, Sun R, Gherga E, Hammoud Y, Rouvier J, Mauvais O, Bockel S, Louvrier A, Lebbad A, Bontemps P, Ortholan C, Bourhis J, Lestrade L, Sun X S
Department of radiotherapy, CHU de Besancon, 2, boulevard Fleming, 25030 Besançon, France; Department of radiotherapy, Hopital Nord Franche-Comté de Montbéliard, site du Mittan, 1 rue Henri Becquerel, 25220 Montbéliard, France.
Department of radiotherapy, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
Cancer Radiother. 2020 Dec;24(8):812-819. doi: 10.1016/j.canrad.2020.03.013. Epub 2020 Nov 2.
To assess the efficacy and the tolerance of a split course hypofractionated (SCH) radiotherapy (RT) protocol in head and neck cancer (HNC) for eldery and/or unfit patients (pts).
Pts with HNC treated by SCH-RT in two institutions were included retrospectively. The main SCH RT regimen was two courses of 30 grays (Gy)/10 fractions separated by 2-4 weeks, without any systemic therapy.
Between February 2012 and January 2019, 75 consecutive patients were analyzed. The median age was 80 years (range: 45.7-98.2) and 53 (70.7%) were men. Sixty-one (81.3%) pts had stage III/IV disease and 54 (72%) had at least two comorbidities. All of them were treated with intensity-modulated radiotherapy. Median follow-up was 10.6 months (range: 3.1-58.3). Local control at 12 and 24 months was 72.8% IC95%[62-85.5] and 51.7% IC95%[38.1-70.1] respectively. Progression free survival (PFS) at 12 and 24 months were 47.7% IC95%[37.4-60.8] and 41% IC95%[15-36.4] respectively, with a median of 11.5 months IC95%[8.9-17]. OS at 12 and 24 months were 60.4% IC95%[50-73.1] and 41% IC95%[30.6-54.9] respectively, with a median of 19.3 months IC95%[11.9-25.8]. Acute and late grade 3 or higher toxicities occurred for 6 (8%) and 3 (4%) pts.
The present SCH-RT regimen seems effective, well-tolerated and could represent an alternative to palliative strategies for pts deemed unfit for standard exclusive RT.
评估分割疗程超分割放疗（SCH）方案对头颈部癌（HNC）老年和/或身体状况不佳患者的疗效和耐受性。
回顾性纳入在两家机构接受SCH-RT治疗的HNC患者。主要的SCH RT方案为两个疗程，每个疗程30格雷（Gy）/10次分割，间隔2-4周，不进行任何全身治疗。
2012年2月至2019年1月期间，对75例连续患者进行了分析。中位年龄为80岁（范围：45.7-98.2岁），53例（70.7%）为男性。61例（81.3%）患者为III/IV期疾病，54例（72%）至少有两种合并症。所有患者均接受调强放疗。中位随访时间为10.6个月（范围：3.1-58.3个月）。12个月和24个月时的局部控制率分别为72.8%，95%置信区间[62-85.5]和51.7%，95%置信区间[38.1-70.1]。12个月和24个月时的无进展生存期（PFS）分别为47.7%，95%置信区间[37.4-60.8]和41%，95%置信区间[15-36.4]，中位PFS为11.5个月，95%置信区间[8.9-17]。12个月和24个月时的总生存期（OS）分别为60.4%，95%置信区间[50-73.1]和41%，95%置信区间[30.6-54.9]，中位OS为19.3个月，95%置信区间[11.9-25.8]。6例（8%）和3例（4%）患者发生了3级或更高等级的急性和晚期毒性反应。
目前的SCH-RT方案似乎有效且耐受性良好，对于被认为不适合标准单纯放疗的患者而言，可能是姑息治疗策略的一种替代方案。
