局部晚期下咽癌调强放疗剂量分割模式改变对急性放疗反应的影响*

蔡博宁; 马林; 鞠忠建; 曲宝林; 徐寿平; 刘海霞

doi:10.3969/j.issn.1000-8179.20150681

局部晚期下咽癌调强放疗剂量分割模式改变对急性放疗反应的影响*

作者单位:中国人民解放军总医院放射治疗科(北京市100853)

详细信息

通讯作者:
马林

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出版历程
- 修回日期: 2015-07-15
- 发布日期: 2015-08-14

Effect of hypofractionated intensity-modulated radiation therapy on acute toxicities for locally advanced squamous cell carcinoma of the hypopharynx

Department of Radiation Oncology, Chinese PLA General Hospital, Beijing100853, China.

More Information

Corresponding author:
Lin MA;malinpharm@sina.com

摘要

摘要: 目的：评价改变剂量分割模式的调强放疗同步联合化疗治疗局部晚期下咽鳞癌的安全性。方法：对解放军总医院调强放疗（IMRT）联合含顺铂方案化疗的下咽鳞癌患者进行改变分割剂量的研究。以pGTV 的处方剂量分为2 组：常规剂量组（组1）自2008年8 月至2013年2 月，为回顾性分析，pGTV 处方剂量70Gy，2.12Gy/f ，共33次，5 次/ 周；试验剂量组（组2）自2013年2 月开始，为前瞻性分析，pGTV 处方剂量69Gy，2.30Gy/f ，共30次，5 次/ 周。比较两种剂量分割模式对急性不良反应的影响。结果：自2008年8 月1 日至2014年12月1 日共76例符合入组条件的患者完成放疗，其中组1 含35例，组2 含41例。全组患者无3 级口干症，3 级皮肤损伤、口腔黏膜炎及吞咽困难的发生率较低，无≥ 4 级不良反应。两组的急性皮肤损伤、口干症、口腔黏膜炎、吞咽困难比较差异无统计学意义（P > 0.05）。IMRT 技术差异对急性不良反应无明显影响。诱导化疗（ICT ）为急性口干症的独立性影响因子（P = 0.002）。结论：初步结果显示，69Gy/30f 剂量分割模式 IMRT 在下咽癌安全有效，远期不良反应及疗效仍需进一步观察。
- 放射治疗 /
- 下咽 /
- 鳞癌
Abstract: Objective: To evaluate the feasibility of hypofractionated intensity- modulated radiation therapy (IMRT) combined with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the hypopharynx. Methods:Patients with stageⅢ- ⅣA carcinoma of the hypopharynx were treated with IMRT and cisplatin-based concurrent chemotherapy. Two groups were di -vided according to the prescription dose to the primary gross tumor volume, as follows: Cohort- 1 comprised patients who were recruit -ed before February 2013(70Gy/33F and2.12Gy/F); and Cohort- 2 comprised patients who were recruited since February 2013(69Gy/30F and 2.30Gy/F). Acute toxicities were evaluated. This study was registered with the number ChiCTR-ONRC- 14004240. Results: Between August 2008and December 2014, a total of 76patients ( 35in Cohort-1 and 41in Cohort-2) were recruited. No xerostomia of grade3 and higher was observed in all patients, who showed low incidences of grade3 skin reaction, oral mucositis, and dysphagia. All patients did not show acute toxicities of higher than grade 4. No statistical differences in acute toxicities were observed between the two cohorts. No statistical difference was observed in acute toxicities between the IMRT techniques. Induction chemotherapy was the inde -pendent prognostic factor for grade 2 xerostomia (P=0.002). Conclusion:The 69Gy/30F hypofractionated IMRT was safe and effec-tive in the treatment of locally advanced squamous cell carcinoma of the hypopharynx. Late toxicities and long-term outcome need to be investigated further.
- radiotherapy /
- hypopharynx /
- squamous cell carcinoma

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