PROSPECTIVE TRIAL OF HIGH-DOSE REIRRADIATION USING DAILY IMAGE GUIDANCE WITH INTENSITY-MODULATED RADIOTHERAPY FOR RECURRENT AND SECOND PRIMARY HEAD-AND-NECK CANCER
PROSPECTIVE TRIAL OF HIGH-DOSE REIRRADIATION USING DAILY IMAGE GUIDANCE WITH INTENSITY-MODULATED RADIOTHERAPY FOR RECURRENT AND SECOND PRIMARY HEAD-AND-NECK CANCER
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DOI：
10.1016/j.ijrobp.2010.02.023
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发表时间：
2011-07-01
影响因子：
7
通讯作者：
Purdy, James A.
中科院分区：
文献类型：
--
作者：
Chen, Allen M.;Farwell, D. Gregory;Purdy, James A.
目的：报告一个单一的机构的经验，使用调强放疗与日常图像引导放疗的复发和第二癌症的再照射的头部和neck.Methods和材料：21例连续的患者进行了前瞻性治疗，从2006年2月至2009年3月的中位剂量为66戈伊（范围，60 - 70戈伊）的调强放疗。这些患者均未接受同期化疗。每日螺旋兆伏级CT扫描之前，每个部分作为图像引导的放射治疗注册协议的一部分，患者alignment.Results：1年和2年的估计，在现场控制分别为72%和65%。每天共进行651次兆伏级CT扫描。平均系统移位，以解释骨折间运动，分别为1.38 +/-1.25 mm，1.79 +/-1.45 mm和1.98 +/-1.75 mm，内外，上级和前后方向。治疗前移位> 3 mm分别发生在19%的内侧、27%的上级和33%的前后方向。无治疗相关死亡或住院。并发症包括皮肤脱屑，odynophagia，外耳道炎，角膜炎，鼻泪管狭窄，和brachial plexopathy.Conclusions：调强放疗与日常图像引导的结果在有效的疾病控制相对较低的发病率，并应考虑为选定的复发性和第二原发性头颈癌患者。(C)2011 Elsevier Inc.
Purpose: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck.Methods and Materials: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment.Results: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 +/- 1.25 mm, 1.79 +/- 1.45 mm, and 1.98 +/- 1.75 mm for the medial lateral, superior inferior, and anterior posterior directions, respectively. Pretreatment shifts of > 3 mm occurred in 19% of setups in the medial lateral, 27% in the superior inferior, and 33% in the anterior posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy.Conclusions: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck. (C) 2011 Elsevier Inc.