INTENSITY-MODULATED RADIOTHERAPY IN POSTOPERATIVE TREATMENT OF ORAL CAVITY CANCERS
INTENSITY-MODULATED RADIOTHERAPY IN POSTOPERATIVE TREATMENT OF ORAL CAVITY CANCERS
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DOI：
10.1016/j.ijrobp.2008.05.024
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发表时间：
2009-03-15
影响因子：
7
通讯作者：
Lee, Nancy Y.
中科院分区：
文献类型：
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作者：
Gomez, Daniel R.;Zhung, Joanne E.;Lee, Nancy Y.
目的：介绍单院调强放疗治疗口腔癌的经验。方法与材料：2000年9月至2006年12月，35例经组织学证实的口腔鳞状细胞癌患者行手术治疗，术后行IMRT。包括颊黏膜8例，口腔舌11例，口腔底9例，牙龈4例，硬腭2例，磨牙后三角区1例。大多数患者为III-IV期（80%）。10例患者（29%）同时接受了术后化疗和IMRT。中位处方辐射剂量为60戈瑞。结果：存活患者的中位随访时间为28.1个月（范围11.9-85.1）。治疗失败11例，局部4例，局部2例，远处转移5例。5例远处转移患者中，2例出现真皮转移。2年和3年的局部无进展生存期、远处无转移生存期、无病生存期和总生存期分别为84%和77%、85%和85%、70%和64%、74%和74%。急性2级及以上皮炎、粘膜炎和食管反应分别发生在54%、66%和40%的患者中。记录的晚期并发症包括牙关（17%）和骨放射性坏死（5%）。结论：IMRT作为口腔肿瘤手术切除后的辅助治疗是可行和有效的，效果良好，毒性可接受。(C) 2009爱思唯尔公司
Purpose: To present our single-institution experience of intensity-modulated radiotherapy (IMRT) for oral cavity cancer.Methods and Materials: Between September 2000 and December 2006, 35 patients with histologically confirmed squamous cell carcinoma of the oral cavity underwent surgery followed by postoperative IMRT. The sites included were buccal mucosa in 8, oral tongue in 11, floor of the mouth in 9, gingiva in 4, hard palate in 2, and retromolar trigone in 1. Most patients had Stage III-IV disease (80%). Ten patients (29%) also received concurrent postoperative chemotherapy with IMRT. The median prescribed radiation dose was 60 Gy.Results: The median follow-up for surviving patients was 28.1 months (range, 11.9-85.1). Treatment failure occurred in 11 cases as follows: local in 4, regional in 2, and distant metastases in 5. Of the 5 patients with distant metastases, 2 presented with dermal metastases. The 2- and 3-year estimates of locoregional progression-free survival, distant metastasis-free survival, disease-free survival, and overall survival were 84% and 77%, 85% and 85%, 70% and 64%, and 74% and 74%, respectively. Acute Grade 2 or greater dermatitis, mucositis, and esophageal reactions were experienced by 54%, 66%, and 40% of the patients, respectively. Documented late complications included trismus (17%) and osteoradionecrosis (5%).Conclusion: IMRT as an adjuvant treatment after surgical resection for oral cavity tumors is feasible and effective, with promising results and acceptable toxicity. (C) 2009 Elsevier Inc.