Ujjayani Sneha, Janaki Manur Gururajachar
Department of Radiation Oncology, Ramaiah Medical College, Bangalore, 560054 Karnataka India.
Indian J Surg Oncol. 2025 Apr;16(2):516-520. doi: 10.1007/s13193-024-01905-1. Epub 2024 Feb 24.
Tolerance to radiation depends on the tumor volume; the greater the volume, the higher the toxicities. In this study, we aimed to study the impact of planning target volume (PTV) on toxicities in head and neck cancer (HNC) patients assigned to receive radiation with or without chemotherapy. Planning target volume (PTV) of 35 histologically proven non-nasopharyngeal head and neck cancer patients undergoing radiation with or without chemotherapy was recorded in cubic centimeters (cc). Their PTV high risk (PTVH) and PTV low risk (PTVL) were correlated with mucositis and dermatitis assessed weekly during treatment and at 2 weeks and 6 weeks post treatment. Thirty-five patients were treated with chemoradiation. Their mean PTVH was 278.08 cc (83-812 cc). The mean PTVL was 505.5 (44-1173 cc). Grade II and above mucositis was seen around fourth week and dermatitis and dysphagia by the end of fifth week which persisted till 2 weeks post follow-up in majority of patients. A cutoff of PTVH > 220 cc and PTVL > 550 cc correlated with grade 2 and above toxicities. Head and neck cancer patients with PTV 66 Gy > 220 cc need to be monitored closely during chemoradiation as they are likely to develop severe grades of toxicities.
对辐射的耐受性取决于肿瘤体积；体积越大，毒性越高。在本研究中，我们旨在研究计划靶体积（PTV）对接受放疗或不放化疗的头颈癌（HNC）患者毒性的影响。记录了35例经组织学证实的非鼻咽癌患者在接受放疗或不放化疗时的计划靶体积（PTV），单位为立方厘米（cc）。他们的高风险计划靶体积（PTVH）和低风险计划靶体积（PTVL）与治疗期间每周以及治疗后2周和6周评估的黏膜炎和皮炎相关。35例患者接受了放化疗。他们的平均PTVH为278.08 cc（83 - 812 cc）。平均PTVL为505.5（44 - 1173 cc）。大多数患者在第四周左右出现II级及以上黏膜炎，在第五周结束时出现皮炎和吞咽困难，这些症状一直持续到随访后2周。PTVH＞220 cc和PTVL＞550 cc的临界值与2级及以上毒性相关。PTV＞220 cc的头颈癌患者在放化疗期间需要密切监测，因为他们可能会出现严重程度的毒性反应。
