A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma
A comparison of intensity-modulated radiation therapy and concomitant boost radiotherapy in the setting of concurrent chemotherapy for locally advanced oropharyngeal carcinoma
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DOI：
10.1016/j.ijrobp.2006.06.040
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发表时间：
2006-11-15
影响因子：
7
通讯作者：
Zelefsky, Michael J.
中科院分区：
文献类型：
--
作者：
Lee, Nancy Y.;de Arruda, Fernando F.;Zelefsky, Michael J.
(目的：)在BAR下，本研究的目的是比较在同期化疗(CT)的情况下，采用延迟加速相伴强化放疗(CBRT)和调强放疗(IMRT)的局部晚期口咽癌常规放射治疗的毒性/疗效。(方法和材料：1998年9月至2004年6月，在BAR下，共有293例口咽癌患者在BAR下接受治疗。在这些人中，112人患有III/IV期疾病和鳞状细胞组织学。其中41例接受调强放疗/CT治疗，71例接受CBRT/CT治疗，中位剂量均为70Gy.最常见的CT检查是计划每3~4周给一次顺铂两个周期，100 mg/m(2)静脉注射，但如果可能的话，调强放疗患者会额外给予一个周期。结果：在BAR条件下，常规放疗患者的中位随访期为46个月(3~93个月)，调强放疗组为31个月(20~个月)。CBRT和IMRT患者三年精算无局部进展、无区域进展、无局部进展、无远处转移、无远处转移的存活率分别为85%比95%(p=0.17)、95%比94%(p=0.90)、82%比92%(p=0.18)、85%比86%(p=0.78)、76%比82%(P=0.57)和81%比91%(p=0.10)。分别进行了分析。CBRT组有3名患者死于与治疗相关的毒性反应，而没有接受调强放疗的患者。两年后，4%的调强放疗患者依赖于经皮内窥镜胃造瘘术(p=0.02)，而21%的患者依赖于经皮内窥镜胃造瘘术(p=0.02)。在L随访20个月的患者中，根据放射治疗和肿瘤组的标准，口腔干燥症的分级为67%，对照组为12%(p=0.02)。(结论：在CT定位的BAR条件下，局部晚期口咽癌的调强放疗与单纯调强放疗相比，毒性更低，疗效相似。(C)2006年爱思唯尔公司。
(Purpose: ) under bar The aim of this study was to compare toxicity/efficacy of conventional radiotherapy using delayed accelerated concomitant boost radiotherapy (CBRT) vs. intensity-modulated radiotherapy (IMRT) in the setting of concurrent chemotherapy (CT) for locally advanced oropharyngeal carcinoma.(Methods and Materials: ) under bar Between September 1998 and June 2004, a total of 293 consecutive patients were treated at our institution for cancer of the oropharynx. Of these, 112 had Stage III/IV disease and squamous cell histology. In all, 41 were treated with IMRT/CT and 71 were treated with CBRT/CT, both to a median dose of 70 Gy. Most common CT was a planned two cycles given every 3 to 4 weeks of cisplatin, 100 mg/m(2) i.v., but an additional cycle was given to IMRT patients when possible. Both groups were well-matched for all prognostic factors.(Results: ) under bar Median follow-up was 46 months (range, 3-93 months) for the CBRT patients and 31 months (range, 20-64 months) for the IMRT group. Three-year actuarial local-progression-free, regional-progression-free, locoregional progression-free, distant-metastases-free, disease-free, and overall survival rates were 85% vs. 95% (p = 0.17), 95% vs. 94% (p = 0.90), 82% vs. 92% (p = 0.18), 85% vs. 86% (p = 0.78), 76% vs. 82% (P = 0.57), and 81 % vs. 91 % (p = 0.10) for CBRT and IMRT patients, respectively. Three patients died of treatment-related toxicity in the CBRT group vs. none undergoing IMRT. At 2 years, 4 % IMRT patients vs. 21 % CBRT patients were dependent on percutaneous endoscopic gastrostomy (p = 0.02). Among those who had L-20 months follow-up, there was a significant difference in Grade >= 2 xerostomia as defined by the criteria of the Radiation Therapy and Oncology Group, 67% vs. 12% (p = 0.02), in the CBRT vs. IMRT arm.(Conclusion:) under bar In the setting of CT for locally advanced oropharyngeal carcinoma, IMRT results in lower toxicity and similar treatment outcomes when compared with CBRT. (c) 2006 Elsevier Inc.