Multi-institutional trial of accelerated hypofractionated intensity-modulated radiation therapy for early-stage oropharyngeal cancer (RTOG 00-22).
Multi-institutional trial of accelerated hypofractionated intensity-modulated radiation therapy for early-stage oropharyngeal cancer (RTOG 00-22).
复制标题
DOI：
10.1016/j.ijrobp.2009.04.011
复制
发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Ang KK
中科院分区：
文献类型：
--
作者：
Eisbruch A;Harris J;Garden AS;Chao CK;Straube W;Harari PM;Sanguineti G;Jones CU;Bosch WR;Ang KK
评估早期口咽癌调强放射治疗（IMRT）的多机构研究结果。需要双侧颈部治疗的T1-2、N 0 -1、M0期口咽癌患者合格。不允许化疗。原发性肿瘤和受累淋巴结的预定计划靶体积（PTVs）剂量为66戈伊，2.2戈伊/次，持续6周。亚临床PTV同时接受54-60戈伊，剂量为1.8-2.0戈伊/次。参与机构预先获得IMRT批准，并由图像引导治疗中心进行质量保证审查。69名患者来自14个机构。存活患者的中位随访时间为2.8年，2年估计局部区域失败（LRF）率为9%。2/4例（50%）发生严重剂量不足偏离的患者发生LRF，而3/49例（6%）未发生此类偏离（p=0.04）。所有LRF、转移或第二原发癌病例均发生在当前/既往吸烟者患者中，而从不吸烟的患者中无一例发生。最大晚期毒性≥ 2级为皮肤12%、粘膜24%、唾液67%、食管19%、放射性骨坏死6%。长期随访显示所有类别的晚期毒性降低。在6个月时，55%的患者观察到口干≥ 2级，但在12个月和24个月时分别降至25%和16%。相比之下，唾液分泌量并没有随着时间的推移而恢复。早期口咽癌患者行中等加速大分割调强放疗而不化疗是可行的，与以往RTOG研究中的类似患者相比，肿瘤控制率高，唾液毒性降低。主要目标剂量不足偏离与较高的LRF率相关。
To assess results of a multi-institutional study of Intensity-Modulated Radiation Therapy (IMRT) for early oropharyngeal cancer. Patients with oropharyngeal carcinoma stage T1-2, N0-1, M0 requiring treatment of the bilateral neck were eligible. Chemotherapy was not permitted. Prescribed planning target volumes (PTVs) doses to primary tumor and involved nodes was 66 Gy at 2.2 Gy/fraction over 6 weeks. Sub-clinical PTVs received simultaneously 54-60 Gy at 1.8-2.0 Gy/fraction. Participating institutions were pre-approved for IMRT, and quality assurance review performed by the Image–Guided Therapy Center. 69 patients accrued from 14 institutions. At median follow-up for surviving patients 2.8 years, 2-year estimated local-regional failure (LRF) rate was 9%. 2/4 patients (50%) with major under-dose deviations had LRF, compared with 3/49 (6%) without such deviations (p=0.04). All cases of LRF, metastasis, or second primary cancer, occurred among patients who were current/former smokers, and none among patients who never smoked. Maximal late toxicities grade ≥ 2 were skin 12%, mucosa 24%, salivary 67%, esophagus 19%, osteoradionecrosis 6%. Longer follow-up revealed reduced late toxicity in all categories. Xerostomia grade ≥ 2 was observed in 55% of patients at 6 months but reduced to 25% and 16% at 12 and 24 months, respectively. In contrast, salivary output did not recover over time. Moderately accelerated hypofractionatd IMRT without chemotherapy for early oropharyngeal cancer is feasible, achieving high tumor control rates and reduced salivary toxicity compared with similar patients in previous RTOG studies. Major target under-dose deviations were associated with higher LRF rate.
登录
查看更多内容
DOI：
10.1016/j.ijrobp.2008.02.016
发表时间：
2008-11-15
影响因子：
7
作者：
Seung, Steven;Bae, Joseph;Cha, Christine
通讯作者：
Cha, Christine
影响因子：
1.9
作者：
FLEMING, TR
通讯作者：
FLEMING, TR
影响因子：
45.3
作者：
Brizel, DM;Wasserman, TH;Sauer, R
通讯作者：
Sauer, R
DOI：
10.1016/j.ijrobp.2003.08.004
发表时间：
2004-05-01
影响因子：
7
作者：
Chao, KSC;Ozyigit, G;Sessions, DG
通讯作者：
Sessions, DG
DOI：
10.1097/01.coc.0000242294.89536.d6
发表时间：
2006-12-01
影响因子：
2.6
作者：
Yao, Min;Nguyen, Thanh;Hoffman, Henry T.
通讯作者：
Hoffman, Henry T.