局部晚期头颈部癌症是否是加速超分割的另一个候选方案？

Is Locally Advanced Head-Neck Cancer One More Candidate for Accelerated Hypofractionation?

机构信息

1 Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Anticancer Res. 2021 Jan;41(1):467-475. doi: 10.21873/anticanres.14797.

DOI:10.21873/anticanres.14797

PMID:33419845

Abstract

BACKGROUND/AIM: Hypofractionated accelerated radiotherapy (HypoAR) is widely applied for the treatment of early laryngeal cancer. Its role in locally advanced head-neck cancer (LA-HNC) is unexplored.

PATIENTS AND METHODS

We present results of a prospective trial on 124 patients with LA-HNC, treated with radio-chemotherapy with three different HypoAR fractionations (3.5 Gy/day × 14-15 fractions, 2.7 Gy/day × 20-21 fractions, and 2.5 Gy/day × 21-22 fractions).

RESULTS

Protraction of the overall treatment time due to oropharyngeal mucositis was enforced in 18/57 laryngeal, 6/19 nasopharyngeal, and 15/48 cancer patients with other tumors. Regarding late toxicities, laryngeal edema grade 3 was noted in 5/57 patients with laryngeal cancer, while severe dysphagia was noted in 4/124 and tracheoesophageal fistula formation in 1/124 patients. The complete response rates obtained were 73%, 84%, and 67% in patients with laryngeal, nasopharyngeal, and other tumors, respectively. The 3-year locoregional progression-free survival was 58%, 73%, and 55%, respectively.

CONCLUSION

HypoAR chemoradiotherapy is feasible, with acceptable early and late radiotherapy toxicities, response rates and LPFS.

摘要

背景/目的：HypoAR（低分割加速放疗）被广泛应用于早期喉癌的治疗。但其在局部晚期头颈部癌症（LA-HNC）中的作用尚未被探索。

患者与方法

我们提出了一项前瞻性试验的结果，该试验纳入了 124 例 LA-HNC 患者，他们接受了放射化学治疗，其中使用了三种不同的 HypoAR 分割方案（3.5 Gy/天×14-15 次，2.7 Gy/天×20-21 次和 2.5 Gy/天×21-22 次）。

结果

由于口咽黏膜炎，18/57 例喉癌、6/19 例鼻咽癌和 15/48 例其他肿瘤患者的整体治疗时间延长。关于晚期毒性，5/57 例喉癌患者出现喉水肿 3 级，124 例患者中有 4 例出现严重吞咽困难，1 例出现气管食管瘘。喉癌、鼻咽癌和其他肿瘤患者的完全缓解率分别为 73%、84%和 67%。3 年局部区域无进展生存率分别为 58%、73%和 55%。