INTENSITY-MODULATED RADIOTHERAPY FOR HEAD-AND-NECK CANCER IN THE COMMUNITY SETTING
INTENSITY-MODULATED RADIOTHERAPY FOR HEAD-AND-NECK CANCER IN THE COMMUNITY SETTING
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DOI：
10.1016/j.ijrobp.2008.02.016
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发表时间：
2008-11-15
影响因子：
7
通讯作者：
Cha, Christine
中科院分区：
文献类型：
--
作者：
Seung, Steven;Bae, Joseph;Cha, Christine
目的：回顾调强放射治疗(IMRT)在社区环境下治疗鼻咽癌和口咽癌的疗效。方法与材料：2003年4月至2007年4月，69例经组织学证实的鼻咽癌和口咽癌患者接受了调强放射治疗。鼻咽11例，舌根18例，扁桃体40例。病期分布：I期2例，II期2例，III期16例，IV期40例。计划靶区的中位剂量为70GY，高危亚临床区的中位剂量为59.4GY，低危区的中位剂量为54Gy.45名患者(65%)同时接受化疗。根据放射治疗肿瘤学小组的毒性标准进行毒性分级。采用Kaplan-Meier积限值法估计无进展生存率和总生存率。结果：中位随访时间为18个月。局部控制率、区域控制率、远控率和总生存率分别为98%、100%、98%和90%。最常见的急性毒性反应是皮炎(1级32例，2级32例，3级5例)，黏膜炎(1级8例，2级33例，3级28例)，口干症(1级0例，2级29例，3级40例)。建议采用系统的内部评审系统进行质量控制，直到积累了足够的经验。(C)2008年爱思唯尔公司。
Purpose: To review outcomes with intensity-modulated radiation therapy (IMRT) in the community setting for the treatment of nasopharyngeal and oropharyngeal cancer.Methods and Materials: Between April 2003 and April 2007, 69 patients with histologically confirmed cancer of the nasopharynx and oropharynx underwent IMRT in our practice. The primary sites included nasopharynx (11), base of tongue (18), and tonsil (40). The disease stage distribution was as follows: 2 Stage I, II Stage II, 16 Stage III, and 40 Stage IV. All were treated with a simultaneous integrated boost IMRT technique. The median prescribed doses were 70 Gy to the planning target volume, 59.4 Gy to the high-risk subclinical volume, and 54 Gy to the low-risk subclinical volume. Forty-five patients (65%) received concurrent chemotherapy. Toxicity was graded according to the Radiation Therapy Oncology Group toxicity criteria. Progression-free and overall survival rates were estimated with the Kaplan-Meier product-limit method.Results: Median duration of follow-up was 18 months. The estimated 2-year local control, regional control, distant control, and overall survival rates were 98%, 100%, 98%, and 90%, respectively. The most common acute toxicities were dermatitis (32 Grade 1, 32 Grade 2, 5 Grade 3), mucositis (8 Grade 1, 33 Grade 2, 28 Grade 3), and xerostomia (0 Grade 1, 29 Grade 2, 40 Grade 3).Conclusions: Intensity-modulated radiotherapy in the community setting can be accomplished safely and effectively. Systematic internal review systems are recommended for quality control until sufficient experience develops. (C) 2008 Elsevier Inc.