Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, U.S.A.
Department of Radiation Oncology, Rush University Cancer Center, Chicago, IL, U.S.A.
Anticancer Res. 2021 Oct;41(10):4995-5000. doi: 10.21873/anticanres.15313.
BACKGROUND/AIM: Head and neck cancers are often treated with extended courses of radiotherapy (RT), which may prove excessively toxic for frail patients. Split course RT (SCRT) delivers two courses of RT separated by 4-6 weeks, personalizing treatment intensity based on response. In this study, we present our updated experience using this technique.
From a single institution database, we identified patients considered for SCRT. For patients undergoing a second course of RT, cumulative incidence of locoregional recurrence (LRR) and overall survival (OS) are reported.
A total of 98 patients were included, of whom seventy-five percent underwent a second course of RT. The most common fractionation was 30 Gy in 10 fractions for each course, with a median cumulative dose of 60 Gy. In those undergoing a second course of RT, median OS was 9.7 months and cumulative incidence of LRR at 6, 12, and 24 months was 17.0%, 23.1%, and 29.4%, respectively.
SCRT offers an attractive treatment paradigm to personalize radiation intensity based on patient tolerance, while maintaining reasonable safety and efficacy in those unfit for standard full course RT.
背景/目的：头颈部癌症常采用延长放疗（RT）疗程进行治疗，但这种治疗对体弱患者可能毒性过大。分割疗程放疗（SCRT）将两个疗程的 RT 间隔 4-6 周进行，根据反应强度调整治疗强度。本研究介绍了我们使用这种技术的最新经验。
我们从一个单机构数据库中确定了考虑 SCRT 的患者。对于接受第二次 RT 治疗的患者，报告局部区域复发（LRR）和总生存（OS）的累积发生率。
共纳入 98 例患者，其中 75%接受了第二次 RT 治疗。最常见的分割方案为每个疗程 30 Gy，共 10 次，累积剂量中位数为 60 Gy。在接受第二次 RT 治疗的患者中，中位 OS 为 9.7 个月，6、12 和 24 个月时 LRR 的累积发生率分别为 17.0%、23.1%和 29.4%。
SCRT 提供了一种有吸引力的治疗模式，可以根据患者的耐受性来个性化调整放射强度，同时为不适合标准全程 RT 的患者提供合理的安全性和疗效。
