IMRT REIRRADIATION OF HEAD AND NECK CANCER-DISEASE CONTROL AND MORBIDITY OUTCOMES
IMRT REIRRADIATION OF HEAD AND NECK CANCER-DISEASE CONTROL AND MORBIDITY OUTCOMES
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DOI：
10.1016/j.ijrobp.2008.04.021
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发表时间：
2009-02-01
影响因子：
7
通讯作者：
Garden, Adam S.
中科院分区：
文献类型：
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作者：
Sulman, Erik P.;Schwartz, David L.;Garden, Adam S.
目的：机构和合作团体的经验证明了头颈癌再照射的可行性。关于针对该适应症使用调强放射治疗 (IMRT) 的可用数据有限。我们回顾了我们对先前接受过放射治疗的头颈癌患者使用 IMRT 的初步经验。方法和材料：回顾了 1999 年至 2004 年间连续 78 名因头颈癌接受 IMRT 再放射治疗的患者的记录；分析了74个案例。再照射被定义为原始放射治疗体积和新放射治疗体积之间的任何重叠，无论初始治疗和后续治疗之间的时间间隔如何。与再辐射相关的严重毒性被定义为导致住院、矫正手术或患者死亡的毒性事件。通过 Kaplan-Meier 技术计算纵向生存估计。结果：20 名 (27%) 患者接受了挽救性手术切除，36 名 (49%) 患者接受了化疗。再照射的中位随访时间为 25 个月。初次放疗和再放疗之间的中位时间间隔为 46 个月。中位再照射剂量为 60 Gy。中位寿命辐射剂量为 116.1 Gy。 2 年总生存率和局部控制率分别为 58% 和 64%。 15 名患者（20%）出现严重的再放疗相关毒性；观察到 1 例与治疗相关的死亡。结论：使用 IMRT 对复发性或继发性原发性头颈癌进行再照射可促进局部控制和生存。与再辐射相关的发病率很高，但可能比以前发表的使用传统技术的报告要轻。 (c) 2009 爱思唯尔公司
Purpose: Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients.Methods and Materials: Records of 78 consecutive patients reirradiated with IMRT for head and neck cancer between 1999 and 2004 were reviewed; 74 cases were analyzed. Reirradiation was defined as any overlap between original and new radiation treatment volumes regardless of the time interval between initial and subsequent treatment. Severe reirradiation-related toxicity was defined as toxic events resulting in hospitalization, corrective surgery, or patient death. Longitudinal estimates of survival were calculated by Kaplan-Meier technique.Results: Twenty (27%) patients underwent salvage surgical resection and 36 (49%) patients received chemotherapy. Median follow-up from reirradiation was 25 months. Median time interval between initial radiation and reirradiation was 46 months. Median reirradiation dose was 60 Gy. Median lifetime radiation dose was 116.1 Gy. The 2-year overall survival and locoregional control rates were 58% and 64%, respectively. Severe reirradiation related toxicity occurred in 15 patients (20%); one treatment-related death was observed.Conclusions: The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques. (c) 2009 Elsevier Inc.