THE EFFECT OF TREATMENT TIME AND TREATMENT INTERRUPTION ON TUMOR-CONTROL FOLLOWING RADICAL RADIOTHERAPY OF LARYNGEAL-CANCER
THE EFFECT OF TREATMENT TIME AND TREATMENT INTERRUPTION ON TUMOR-CONTROL FOLLOWING RADICAL RADIOTHERAPY OF LARYNGEAL-CANCER
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DOI：
10.1016/0167-8140(92)90323-m
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发表时间：
1992-03-01
影响因子：
5.7
通讯作者：
MAKI, E
中科院分区：
文献类型：
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作者：
BARTON, MB;KEANE, TJ;MAKI, E
在对1012例放射性治疗的喉鳞状细胞癌进行回顾性分析时发现，总体治疗时间对局部控制有显著影响。全组5年的精确局部无复发率（LRFR）为59%。治疗时间对局部控制的影响符合线性二次方程。使用逻辑回归分析，治疗时间和剂量具有显著性（分别为p = 0.008和p = 0.04）。当分析调整的影响阶段和喉亚部位治疗时间仍然是一个重要的预后因素（p = 0.02）。γ/α的推导值为0.7戈伊/天，根据分期和子部位调整后为0.8戈伊/天。这相当于维持等效局部控制的剂量增量分别为0.64戈伊/天和0.73戈伊/天，每日分次为2.5戈伊，肿瘤的假定α/β为25戈伊。为了估计未通过剂量递增补偿的治疗中断的临床影响，进行了考克斯回归。显著变量为T分期、N分期、性别、总剂量和治疗中断总时长。使用比例风险模型计算，治疗中断的每一天导致局部复发风险增加4.8%（p = 0.006）。根据我们的数据，计算出这将导致每一天的无补偿治疗中断的局部控制下降1.4%。
A significant effect of overall treatment time on local control was found in a retrospective review of 1012 radically irradiated squamous cell carcinomas of the larynx. The actuarial local relapse free rate (LRFR) at 5 years for the whole group was 59% The effect of treatment time on local control was modelled to the linear-quadratic equation. Using logistic regression analysis treatment time and dose were significant (p = 0.008 and p = 0.04, respectively). When the analysis was adjusted for the influence of stage and laryngeal subsite treatment time remained a significant prognostic factor (p = 0.02). The derived value of gamma/alpha was 0.7 Gy/day and when adjusted for stage and sub-site 0.8 Gy/day. This equates to a dose increment to maintain isoeffective local control of 0.64 Gy/day and 0.73 Gy/day respectively for daily fractions of 2.5 Gy and an assumed alpha/beta for tumour of 25 Gy. To provide an estimate of the clinical impact of treatment interruptions not compensated for by dose escalation a Cox regression was performed. Significant variables were T stage, N stage, sex, total dose and total length of treatment interruption. Using the proportional hazard model it was calculated that each day of treatment interruption resulted in an increase in the hazard of local relapse by 4.8% (p = 0.006). Based on our data it was calculated that this would result in a decrease in local control of 1.4% for each day of uncompensated treatment interruption.