Marcial V A, Pajak T F, Rotman M, Brady L W, Amato D
Radiation Oncology Center, San Juan, Puerto Rico 00918.
Am J Clin Oncol. 1993 Oct;16(5):389-96. doi: 10.1097/00000421-199310000-00004.
The Radiation Therapy Oncology Group conducted a prospective comparison of a compensated split course radiotherapy technique (300 cGy x 10, 3 weeks rest, 300 cGy x 10), versus continuous radiotherapy (200-220 cGy up to 6000-6600 cGy), in 137 evaluable patients. The complete response (CR) was 57% in 63 patients, treated with the split-technique vs 61% in 74 patients submitted to continuous course radiotherapy. The completion of therapy as planned was better in the split-technique, but acute and late tissue reactions were the same. Locoregional control of tumor at 5 years was 25% for split and 28% for continuous therapy. At 7 years this was 25% and 24%, respectively. Absolute survival in the split-course patients tended to be lower than in the continuous group, but when the sample of patients was enlarged by the addition of cases from similar trials of nasopharynx and base of tongue lesions, the survival difference was eliminated. On the basis of the results of this study we conclude that the stated compensated split-course technique gives equal clinical results as conventional continuous therapy, with the advantage of requiring fewer radiation fractions, and less burden on the patient and therapy facilities.
放射治疗肿瘤学组对137例可评估患者进行了前瞻性比较，比较了一种补偿性分割疗程放疗技术（300厘戈瑞×10次，休息3周，300厘戈瑞×10次）与连续放疗（200 - 220厘戈瑞，直至6000 - 6600厘戈瑞）的效果。采用分割技术治疗的63例患者中，完全缓解（CR）率为57%，而接受连续疗程放疗的74例患者中这一比例为61%。分割技术组按计划完成治疗的情况更好，但急性和晚期组织反应相同。5年时肿瘤的局部区域控制率，分割治疗组为25%，连续治疗组为28%。7年时分别为25%和24%。分割疗程患者的绝对生存率往往低于连续治疗组，但当通过纳入鼻咽癌和舌根病变类似试验的病例扩大患者样本时，生存差异消失。基于本研究结果，我们得出结论，所述的补偿性分割疗程技术与传统连续治疗具有相同的临床效果，其优点是所需放疗次数更少，对患者和治疗设施的负担更小。
