Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy.
Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy.
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DOI：
10.1186/1748-717x-6-54
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发表时间：
2011-05-24
期刊：
影响因子：
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通讯作者：
Sen M
中科院分区：
文献类型：
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作者：
Oksuz DC;Prestwich RJ;Carey B;Wilson S;Senocak MS;Choudhury A;Dyker K;Coyle C;Sen M
为了建立接受根治性(化疗)放疗的局部晚期头颈部非鼻咽癌(HNSCC)患者的复发模式，并将局部复发的部位与放疗剂量和靶区体积相关联，我们在2004-2005年间采用根治性三维适形放射治疗了151例局部晚期HNSCC患者。有原发肿瘤部位手术史的患者被排除在外。局部复发的部位与放射科医生和计划剂量师的放射治疗计划相关。中位年龄59岁(范围34-89岁)。Ⅲ期35例，IVA/B期116例。单纯放疗组36例，诱导化疗组42例，诱导放化疗组63例，同期放化疗组10例。中位随访期38个月(范围3-62个月)。3年特定原因生存率为66.8%。治疗完全缓解125例(82.8%)。125例中有20例局部区域复发，其中8例局部复发，5例区域复发，7例同时发生局部和区域转移，7例同时发生远处转移，9例发生远处转移，无局部区域转移。在有规划数据的14次局部复发中，12次在现场，1次在边缘，1次在场外。在有规划数据的11个区域故障中，7个是现场故障，1个是边缘故障，3个是外地复发。大多数局部晚期HNSCC非手术治疗失败是局部区域的，在放射治疗的靶区范围内。改善区域控制仍然是一个高度优先事项。
To establish recurrence patterns among locally advanced head and neck non-nasopharyngeal squamous cell carcinoma (HNSCC) patients treated with radical (chemo-) radiotherapy and to correlate the sites of loco-regional recurrence with radiotherapy doses and target volumes 151 locally advanced HNSCC patients were treated between 2004-2005 using radical three-dimensional conformal radiotherapy. Patients with prior surgery to the primary tumour site were excluded. The sites of locoregional relapses were correlated with radiotherapy plans by the radiologist and a planning dosimetrist. Median age was 59 years (range:34-89). 35 patients had stage III disease, 116 patients had stage IV A/B. 36 patients were treated with radiotherapy alone, 42 with induction chemotherapy, 63 with induction and concomitant chemoradiotherapy and 10 concomitant chemoradiotherapy. Median follow-up was 38 months (range 3-62). 3-year cause specific survival was 66.8%. 125 of 151 (82.8%) achieved a complete response to treatment. Amongst these 125 there were 20 local-regional recurrence, comprising 8 local, 5 regional and 7 simultaneous local and regional; synchronous distant metastases occurred in 7 of the 20. 9 patients developed distant metastases in the absence of locoregional failure. For the 14 local recurrences with planning data available, 12 were in-field, 1 was marginal, and 1 was out-of-field. Of the 11 regional failures with planning data available, 7 were in-field, 1 was marginal and 3 were out-of-field recurrences. The majority of failures following non-surgical treatment for locally advanced HNSCC were loco-regional, within the radiotherapy target volume. Improving locoregional control remains a high priority.