Salivary glands radiotherapy to reduce sialorrhea in amyotrophic lateral sclerosis: Dose and energy
Salivary glands radiotherapy to reduce sialorrhea in amyotrophic lateral sclerosis: Dose and energy
复制标题
DOI：
10.1016/j.canrad.2013.01.010
复制
发表时间：
2013-06-01
影响因子：
1.3
通讯作者：
Lapeyre, M.
中科院分区：
文献类型：
--
作者：
Bourry, N.;Guy, N.;Lapeyre, M.
目的. - 本回顾性研究评估了唾液腺放射治疗对肌萎缩侧索硬化（ALS）患者减少流涎的有效性。- 从2001年8月至2008年2月，21例肌萎缩侧索硬化症患者（6例男性，15例女性;平均年龄61.2岁，范围39-81岁）接受外照射放射治疗流涎（通过ALS功能评定量表评估）。所有患者既往均接受过药物治疗，结果不满意或有副作用。平均剂量为19.1戈伊（范围3-48），在17天（范围1-77）分5次（范围1-16）输送。8例患者接受三维适形放疗，13例接受二维适形放疗。临床靶体积包括腮腺和颌下腺（18例患者）、颌下腺和一个腮腺（1例患者）或腮腺（2例患者）。13名患者用5.5-6 MV光子治疗，8名患者用6-15 MeV电子治疗。令人满意的唾液应答定义为完全或部分改善。中位随访时间为10.4个月（范围0.4-26）。1例患者失访。- 在平均7个月（范围1-23）内，在65%的患者中观察到阳性反应。4名患者（20%）接受光子治疗，没有患者接受电子治疗出现急性毒性。一半（50%）的患者接受光子治疗，87.5%的患者接受电子治疗的积极反应（P = 0.09）。高总剂量（>= 16戈伊; 78.6%）的阳性反应比低总剂量（
Purpose. - This retrospective study evaluated the effectiveness of salivary gland radiotherapy for reducing sialorrhea in patients with amyotrophic lateral sclerosis (ALS).Patients and methods. - From August 2001 to February 2008, 21 patients with amyotrophic lateral sclerosis (six men, 15 women; mean age 61.2 years, range 39-81) received external beam radiotherapy for sialorrhea (evaluation by the ALS Functional Rating Scale). All patients had previously received pharmacological treatments with unsatisfactory results or side effects. The mean dose was 19.1 Gy (range 3-48), delivered in five fractions (range 1-16) on 17 days (range 1-77). Eight patients received 3D-conformal and 13 received 2D-conformal radiotherapy. Clinical target volumes included the parotids and submandibular glands (18 patients), submandibular glands and one parotid (one patient), or parotids (two patients). Thirteen patients were treated with 5.5-6 MV photons and eight were treated with 6-15 MeV electrons. A satisfactory salivary response was defined as complete or partial improvement. The median follow up was 10.4 months (range 0.4-26). One patient was lost to follow up.Results. - A positive response was observed in 65% of patients during a mean of 7 months (range 1-23). Four patients (20%) treated with photons and no patients treated with electrons experienced acute toxicity. Half (50%) the patients treated with photons and 87.5% of patients treated with electrons responded positively (P = 0.09). Positive responses were more common with a high total dose (>= 16 Gy; 78.6%) than a low total dose (