The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy - The University of Iowa Experience
The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy - The University of Iowa Experience
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DOI：
10.1016/j.ijrobp.2006.11.030
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发表时间：
2007-04-01
影响因子：
7
通讯作者：
Buatti, John M.
中科院分区：
文献类型：
--
作者：
Yao, Min;Chang, Kristi;Buatti, John M.
目的：探讨调强放疗（IMRT）治疗口腔鳞状细胞癌（SCC）的失败模式。方法与材料：2001年5月至2005年7月，对55例口腔鳞状细胞癌患者进行IMRT治疗。49例接受了术后IMRT， 5例接受了明确的IMRT， 1例接受了新辅助。定义了三个靶区（临床靶区CTV1、CTV2和CTV3）。失败模式是通过共配准或治疗计划的计算机断层扫描与复发时获得的图像的比较来确定的。结果：所有患者的中位随访时间为17.1个月（范围0.27 ~ 59.3个月）。在世患者的中位随访时间为23.9个月（9.3-59.3个月）。9例患者发生局部局部失败：4例仅发生局部失败，2例仅发生局部失败，3例同时发生局部和局部失败。5例患者远端失败；其中，3个也有局部区域故障。2年总生存率、疾病特异性生存率、局部无复发生存率、局部区域无复发生存率和远处无疾病生存率分别为68%、74%、85%、82%和89%。从治疗完成到局部复发的中位时间为4.1个月（范围3.0-12.1个月）。除1例患者在辐射场外对侧下颈部失败外，所有患者均在接受高剂量辐射的区域失败。局部区域控制与囊外伸展密切相关。结论：调强放射治疗是治疗口腔鳞状细胞癌的有效方法。大多数故障是现场故障。需要进一步的临床研究来改善具有高危特征的患者的预后，特别是那些囊外延伸的患者。(c) 2007爱思唯尔公司
Purpose: Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT).Methods and Materials: Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence.Results: The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for I patient who failed in contralateral lower neck outside the radiation field, all failed in areas that hail received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension.Conclusions: Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension. (c) 2007 Elsevier Inc.