RESEARCH FOR IMPROVEMENT OF TUMOR CONTROL AND QOL IN THE TREATMENT OF ORAL CANCER BY HYPERFRACTIONATED RADIOTHERAPY WITH AND WITHOUT CHEMOTHERAPY

通过超分割放射治疗联合或不联合化疗改善口腔癌治疗中的肿瘤控制和生活质量的研究

• 批准号: 17591962
• 负责人: FUJITA Minoru
• 金额: $ 2.37万
• 依托单位: Hiroshima University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2007
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17591962/
• 关键词: oral cancer; radiotehrapy; chemotherapy; hyperfractionated radiotherapy

Ninety two patients with previously untreated and biopsy-proven squamous cell carcinoma of the oral cavity were treated by hyperfractionated radiotherapy (HF) with or without chemotherapy (CT) to improve treatment results and quality of life (QOL). Fifty six patients among them were analyzed because an uniform fraction size was used through out their treatment. Ultimate local control rates of 1.2Gy fraction group was 39%, and that of 1.4Gy fraction group was 56%. Among patients received neoadjuvant CT, local control rates of 1.2Gy fraction group was 23%, and that of 1.4Gy fraction group was 100%. Among NO patients, 19/25 patients were alive in 1.2Gy fraction group and 17/22 in 1.4Gy fraction group. In both fraction groups N+ patients were not controlled locally. Among 39 patients who were alive more than 2 years after radiotherapy, 21 had late radiation damages. Those were exfoliation of teeth, bone exposure, and bone necrosis. Nine patients in 21 had late damage after salvage operation.In early stage patients a local conrol rate was about 50% and a cause-specific suvival rate 70-80%. This finding indicated that "operation first" intent should be a better selection sense of treatment. On the other hand, combination of operation and radiotherapy and combination of CT and radiotherapy should be more discussed in advanced cases because regional control was not achieved even in locally-controlled patients. High incidence of late radiation damage must be a big problem on the usage of HF especially for patients with an oral cancer.

对92例未经治疗的口腔鳞状细胞癌患者进行了超分割放疗（HF）联合或不联合化疗（CT）治疗，以改善治疗效果和生活质量（QOL）。其中56名患者进行了分析，因为在整个治疗过程中使用了统一的分数大小。最终局部控制率1.2Gy组为39%，1.4Gy组为56%。在接受新辅助CT的患者中，1.2Gy分割组的局部控制率为23%，1.4Gy分割组的局部控制率为100%。NO组中1.2Gy分割组存活19/25例，1.4Gy分割组存活17/22例。在两个部分组中，N+患者未得到局部控制。放疗后存活2年以上的39例患者中，21例出现晚期放射性损害。包括牙齿脱落，骨外露，骨坏死。21例中9例为晚期损伤，早期损伤局部控制率约50%，特异性生存率70- 80%。这一发现表明，“手术优先”的意图应该是一个更好的选择意义上的治疗。另一方面，在晚期病例中应更多地讨论手术与放射治疗的结合以及CT与放射治疗的结合，因为即使在局部控制的患者中也未实现区域控制。晚期辐射损伤的高发生率一定是使用HF的一个大问题，特别是对于口腔癌患者。