REDUCING THE RISK OF XEROSTOMIA AND MANDIBULAR OSTEORADIONECROSIS: THE POTENTIAL BENEFITS OF INTENSITY MODULATED RADIOTHERAPY IN ADVANCED ORAL CAVITY CARCINOMA
REDUCING THE RISK OF XEROSTOMIA AND MANDIBULAR OSTEORADIONECROSIS: THE POTENTIAL BENEFITS OF INTENSITY MODULATED RADIOTHERAPY IN ADVANCED ORAL CAVITY CARCINOMA
复制标题
DOI：
10.1016/j.meddos.2008.08.008
复制
发表时间：
2009-09-01
影响因子：
1.2
通讯作者：
Nutting, Christopher M.
中科院分区：
文献类型：
--
作者：
Ahmed, Merina;Hansen, Vibeke N.;Nutting, Christopher M.
口腔鳞状细胞癌的放射治疗可能是治愈性的，但对骨、唾液腺和其他软组织有永久性损伤的风险。我们研究了调强放射治疗（IMRT）提高晚期口腔癌（OCC）靶区覆盖率和正常组织保留率的潜力。我们研究了6例需要双侧口腔和颈部照射的晚期OCC患者。采用剂量-体积直方图比较标准三维适形放疗（3DCRT）和逆计划调强放疗的剂量分布。评估了包括脊髓、腮腺和下颌骨在内的风险器官的剂量，作为辐射毒性的替代物。3DCRT的PTV 1平均剂量为60.8 +/- 0.8戈伊，IMRT为59.8 +/- 0.1戈伊（p = 0.04）。3DCRT的PTV 1剂量范围为24.7 +/- 6戈伊，IMRT为15.3 +/- 4戈伊（p = 0.001）。3DCRT和IMRT的PTV 2平均剂量分别为54.5 +/- 0.8戈伊和54.2 +/- 0.2戈伊（p = 0.34）。PTV 2（IMRT改善了丢失范围（7.8 +/- 3.2戈伊vs. 30.7 +/- 12.8戈伊，p = 0.006）。使用IMRT时，PTV 2的均匀性指数（HI）值更接近于1（p = 0.0003）。IMRT的平均腮腺剂量为25.6 +/- 2.7戈伊，3DCRT的平均腮腺剂量为42.0 +/- 8.8戈伊（p = 0.002）。所有IMRT计划中的腮腺V30均为
Radiation therapy for squamous cell carcinoma of the oral cavity may be curative, but carries a risk of permanent damage to bone, salivary glands, and other soft tissues. We studied the potential of intensity modulated radiotherapy (IMRT) to improve target volume coverage, and normal tissue sparing for advanced oral cavity carcinoma (OCC). Six patients with advanced OCC requiring bilateral irradiation to the oral cavity and neck were studied. Standard 3D conformal radiotherapy (3DCRT) and inverse-planned IMRT dose distributions were compared by using dose-volume histograms. Doses to organs at risk, including spinal cord, parotid glands, and mandible, were assessed as surrogates of radiation toxicity. PTV1 mean dose was 60.8 +/- 0.8 Gy for 3DCRTand 59.8 +/- 0.1 Gy for IMRT (p = 0.04). PTV1 dose range was 24.7 +/- 6 Gy for 3DCRT and 15.3 +/- 4 Gy for IMRT (p = 0.001). PTV2 mean dose was 54.5 +/- 0.8 Gy for 3DCRT and for IMRT was 54.2 +/- 0.2 Gy (p = 0.34). PTV2 (lose range was improved by IMRT (7.8 +/- 3.2 Gy vs. 30.7 +/- 12.8 Gy, p = 0.006). Homogeneity index (HI) values for PTV2 were closer to unity using IMRT (p = 0.0003). Mean parotid doses were 25.6 +/- 2.7 Gy for IMRT and 42.0 +/- 8.8 Gy with 3DCRT (p = 0.002). The parotid V30 in all IMRT plans was