THE HAZARD OF ACCELERATED TUMOR CLONOGEN REPOPULATION DURING RADIOTHERAPY
THE HAZARD OF ACCELERATED TUMOR CLONOGEN REPOPULATION DURING RADIOTHERAPY
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DOI：
10.3109/02841868809090333
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发表时间：
1988-01-01
期刊：
影响因子：
3.1
通讯作者：
MACIEJEWSKI, B
中科院分区：
文献类型：
--
作者：
WITHERS, HR;TAYLOR, JMG;MACIEJEWSKI, B
当分析近500例口咽癌患者的放疗结果显示，在约5周至约8周的延长治疗期间，肿瘤快速再生的证据时，我们检索了头颈癌放疗的文献，以确定是否显示了加速肿瘤再生的类似证据。根据已发表的局部控制率，估计达到50%病例局部控制的剂量（TCD 50），并评价这些剂量对总体治疗持续时间的依赖性。同时，分析发表的散点图，以估计从治疗开始后4-10周内肿瘤再生长的速率。这两种分析都表明，平均而言，头颈部鳞状细胞癌中的克隆原再增殖仅在4 ± 1个数量级的滞后期后才加速。1周后开始放疗，需要每天增加约0.6戈伊的剂量以补偿这种再增殖。这种剂量增量与4天克隆原倍增率一致，而在已发表的未受干扰的肿瘤生长率报告中，中位数约为60天。这里给出的值是大量患者的平均值：不仅有必要在前瞻性研究中验证这些回顾性分析的结果，而且还需要开发方法来预测个体患者的发病时间和加速肿瘤克隆原再增殖率。
When analysis of results of radiotherapy for nearly 500 patients with oropharyngeal cancer showed evidence for rapid tumor regrowth during extensions of treatment from about 5 weeks to about 8 weeks, we searched the literature on radiotherapy for head and neck cancer to determine whether it revealed similar evidence fo accelerated tumor regrowth. Estimates of doses to achieve local control in 50% of cases (TCD50) were made from published local control rates, and the dependence of these doses on overall treatment duration was evaluated. In parallel, published scattergrams were analyzed to estimate the rate of tumor regrowth over the period of 4-10 weeks from initiation of therapy. Both analyses suggested, that, on average, clonogen repopulation in squamous cell carcinomas of the head and neck accelerates only after a lag period of the order of 4 .+-. 1 weeks after initiation of radiotherapy and that a dose increment of about 0.6 Gy per day is required to compensate for this repopulation. Such a dose increment is consistent with a 4-day clonogen doubling rate, compared with a median of about 60 days in published reports of unperturbed tumor growth rates. The values presented here are average values for a large number of patients: it is necessary, not only to verify the results of these retrospective analyses in prospective studies, but also to develop methods to predict the time of onset and rate of accelerated tumor clonogen repopulation in the individual patient.