非转移性 IV 期头颈部癌症放疗中常规分割与加速分割联合推量的比较。
Comparison of Conventional Fractionation and Accelerated Fractionation With Concomitant Boost for Radiotherapy of Non-metastatic Stage IV Head-and-Neck Cancer.
机构信息
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
出版信息
In Vivo. 2021 Jan-Feb;35(1):411-415. doi: 10.21873/invivo.12272.
BACKGROUND/AIM: Some patients with unresectable or incompletely resected head-and-neck cancer (SCCHN) cannot tolerate radiochemotherapy. Alternatives are needed that are more effective than conventional radiotherapy alone.
PATIENTS AND METHODS
This retrospective study investigated patients irradiated for non-metastatic stage IV SCCHN who could not receive concurrent chemotherapy. Eight patients received accelerated radiotherapy with concomitant boost (group A) and 31 patients conventionally fractionated radiotherapy (group B). Groups were matched for tumor site, gender, age, performance score and histologic grade.
RESULTS
Two-year PFS-rates were 63% in group A vs. 41% in group B, and median PFS-times were 36 vs. 10 months (p=0.48). Two-year OS-rates were 88% vs. 37%, and median OS-times were 44 vs. 14 months (p=0.19). Grade ≥2 radiation dermatitis was significantly (p=0.040) more common in group B; other toxicities were similar.
CONCLUSION
Accelerated fractionation with concomitant boost appeared superior to conventional fractionation and can be considered for patients with stage IV SCCHN not suitable for radiochemotherapy. Larger studies are needed to confirm these findings.
背景/目的：一些无法进行手术切除或不完全切除的头颈部癌症（SCCHN）患者不能耐受放化疗。需要寻找比单纯常规放疗更有效的替代方案。
患者和方法
本回顾性研究调查了不能接受同期化疗的非转移性 IV 期 SCCHN 放疗患者。8 例患者接受加速放疗联合同期推量（A 组），31 例患者接受常规分割放疗（B 组）。两组在肿瘤部位、性别、年龄、表现评分和组织学分级方面相匹配。
结果
A 组 2 年无进展生存率（PFS）为 63%，B 组为 41%，中位 PFS 时间分别为 36 个月和 10 个月（p=0.48）。A 组 2 年总生存率（OS）为 88%，B 组为 37%，中位 OS 时间分别为 44 个月和 14 个月（p=0.19）。B 组中≥2 级放射性皮炎的发生率显著更高（p=0.040）；其他毒性反应相似。
结论
加速分割放疗联合同期推量似乎优于常规分割放疗，可考虑用于不适合放化疗的 IV 期 SCCHN 患者。需要更大规模的研究来证实这些发现。
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