Intensity-modulated radiation therapy reduces late salivary toxicity without compromising tumor control in patients with oropharyngeal carcinoma: a comparisons with conventional techniques
Intensity-modulated radiation therapy reduces late salivary toxicity without compromising tumor control in patients with oropharyngeal carcinoma: a comparisons with conventional techniques
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DOI：
10.1016/s0167-8140(01)00449-2
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发表时间：
2001-12-01
影响因子：
5.7
通讯作者：
Spector, G
中科院分区：
文献类型：
--
作者：
Chao, KSC;Majhail, N;Spector, G
背景和目的：调强放射治疗（IMRT）为口咽癌患者正常组织保留提供了优越的剂量一致性。在本研究中，比较了常规放射束排列（CRT）和IMRT的急性和晚期毒性以及肿瘤控制。材料和方法：1970年1月至1999年12月，在Mallinckrodt放射研究所治疗了430例口咽癌患者。扁桃体原发肿瘤260例，舌底肿瘤170例。24例（6%）患者为I期疾病，88例（20%）为II期疾病，128例（30%）为III期疾病，190例（44%）为IV期疾病。将患者分为5个治疗组。第一组109例患者术前行CRT。第二组142例患者接受术后CRT治疗。153例患者接受了明确的CRT。采用逆计划IMRT （Peacock， NOMOS）治疗14例术后患者（IV组）和12例完全不手术患者（V组）。根据放射治疗肿瘤组放射发病率标准对急性和晚期正常组织副作用进行评分。中位随访时间为3.9年。结果：5个研究组的2年局部-区域控制值分别为78、76、68、100和88%。5个研究组的2年无病生存率分别为68%、74%、58%、92%和80%。IMRT显著降低了晚期口干症的发生率。结论：当IMRT与传统技术进行比较时，IMRT的剂量学优势确实转化为口咽癌患者晚期唾液毒性的显着降低。在接受IMRT治疗的患者中，未观察到对肿瘤控制和无病生存的不良影响。(C) 2001爱思唯尔科学爱尔兰有限公司版权所有。
Background and purpose: Intensity-modulated radiation therapy (IMRT) offers superior dosimetric conformity for normal tissue sparing in patients with oropharyngeal cancer. In this study, acute and late toxicity, and tumor control were compared between conventional beam arrangement (CRT) and IMRT.Materials and methods: Between January 1970 and December 1999, 430 patients with carcinoma of the oropharynx were treated at the Mallinckrodt Institute of Radiology. There were 260 patients with tonsil primary tumors and 170 patients with tumors arising from the base of the tongue. Twenty-four (6%) patients had stage I disease, 88 (20%) had stage II, 128 (30%) had stage III, and 190 (44%) had stage IV disease. Patients were divided into five treatment groups. Group I consisted of 109 patients who received preoperative CRT. Group II consisted of 142 patients who received postoperative CRT Group III consisted. of 153 patients who received definitive CRT. Inverse planning IMRT (Peacock, NOMOS) was used to treat 14 patients postoperatively (Group IV) and 12 patients definitively without surgery (Group V). Acute and late normal tissue side-effects were scored according to the Radiation Therapy Oncology Group radiation morbidity criteria. The median follow-up was 3.9 years.Results: The 2-year local-regional control values for the five studied groups were 78, 76, 68, 100 and 88%, respectively. The 2-year disease-free survival values for the five studied groups were 68, 74, 58, 92 and 80%, respectively. IMRT significantly reduced the incidence of late xerostomia.Conclusions: When IMRT was compared with conventional techniques, the dosimetric advantage of IMRT did translate into a significant reduction of late salivary toxicity in patients with oropharyngeal carcinoma. No adverse impact on tumor control and disease-free survival was observed in patients treated with IMRT. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.