CAJ | 학술논문

目的:评价螺旋断层根治性放疗联合同步化疗和/或抗 EGFR 单克隆抗体治疗局部晚期下咽癌的疗效及不良反应.方法:回顾性分析螺旋断层根治性放疗联合同步化疗和/或抗EGFR单克隆抗体治疗局部晚期下咽癌患者30例.下咽原发病灶及转移淋巴结根治性放疗计划剂量均为70 Gy/33 F、PTV160 Gy/33 F、PTV254 Gy/33 F.结果:47%患者发生了3~4级急性反应,未发生≥3级的晚期反应.30例患者放疗过程中除2例死于原发部位大出血,其余28例患者中位随访时间为15.5(3~41)个月,1和2年的原发病灶控制率、淋巴结控制率、远处转移控制率和生存率分别为63%和35%、84%和61%、89%和81%、8%和50%.全组患者治疗失败11例,原发病灶进展为最常见的失败原因.结论:螺旋断层放疗联合同步化疗和/或抗EGFR单克隆抗体治疗局部晚期下咽癌患者能很好地耐受,临床疗效较好.
목적:평개라선단층근치성방료연합동보화료화/혹항 EGFR 단극륭항체치료국부만기하인암적료효급불량반응.방법:회고성분석라선단층근치성방료연합동보화료화/혹항EGFR단극륭항체치료국부만기하인암환자30례.하인원발병조급전이림파결근치성방료계화제량균위70 Gy/33 F、PTV160 Gy/33 F、PTV254 Gy/33 F.결과:47%환자발생료3~4급급성반응,미발생≥3급적만기반응.30례환자방료과정중제2례사우원발부위대출혈,기여28례환자중위수방시간위15.5(3~41)개월,1화2년적원발병조공제솔、림파결공제솔、원처전이공제솔화생존솔분별위63%화35%、84%화61%、89%화81%、8%화50%.전조환자치료실패11례,원발병조진전위최상견적실패원인.결론:라선단층방료연합동보화료화/혹항EGFR단극륭항체치료국부만기하인암환자능흔호지내수,림상료효교호.
Objective: This study aimed to evaluate the toxicity and therapeutic effect of radical helical tomotherapy (RHT) combined with concurrent chemotherapy in treating locally advanced hypopharyngeal cancer (HPC). Methods: Thirty patients with locally advanced HPC were treated by RHT combined with concurrent chemotherapy. The RHT dosage was as follows: 70 Gy/33 F was used in the pGTVnx+pGTVnd treatment, 60 Gy/33 F in PTV1, and 54 Gy/33 F in PTV2. Early and late radiation side effects were evaluated against the rating scales of the Radiation Therapy Oncology Group of the European Organization for Research and Treatment. Results: Early side effects (i. e., grades 3 and 4 acute reactions) occurred in 47% of the 30 patients. Late side effects (i.e., grade 3 and higher) were not observed. Among the 30 patients, 2 died during radiotherapy for locoregional hemorrhea. In the other 28 patients, the median of follow-up time was 15.5 months (range = 3–41 months); the one- and two-year local relapse-free, lymph node metastasis-free, distant metastasis-free, and overall survival rates were 63% and 35%, 84% and 61%, 89% and 81%, as well as 58% and 50%, respectively. Treatment failed in 11 cases mainly because of progression of the primary lesion. Conclusion: RHT combined with concurrent chemotherapy for locally advanced hypopharyngeal cancer is well tolerated and rproduces satisfactory clinical outcomes.