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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >The impact of treatment modality and radiation technique on outcomes and toxicity of patients with locally advanced oropharyngeal cancer
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The impact of treatment modality and radiation technique on outcomes and toxicity of patients with locally advanced oropharyngeal cancer

机译：治疗方式和放射技术对局部晚期口咽癌患者预后和毒性的影响

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Objectives/Hypothesis: To investigate the impact of treatment modality and radiation technique on oncologic outcomes and toxicity of patients with locally advanced oropharyngeal cancer (OPC). Study Design: Retrospective analysis of outcomes and toxicity. Methods: Between 2000 and 2011, 204 consecutive patients with locally advanced OPC were treated with definitive (chemo)radiotherapy using 3-dimensional conformal (3DCRT) or intensity-modulated radiotherapy (IMRT). Endpoints were local control (LC), regional control (RC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), and toxicity. Results: After a median follow-up of 44 months (range 4-134), the 5-year Kaplan-Meier estimates of LC, RC, DFS, CSS, and OS were 78%, 92%, 60%, 64%, and 48%, respectively. Grade 3 mucositis and dysphagia (feeding-tube dependency) were reported in 75% and 65%, respectively. The overall incidence of grade ≥2 and grade 3 late toxicities were 44% and 16%, respectively. Dysphagia and xerostomia were the most frequently reported late toxicity. Chemotherapy was significantly predictive for improved outcomes and increased toxicity. IMRT was significantly correlated with reduced toxicity. Conclusions: Compared to radiation alone, chemoradiotherapy significantly improved oncologic outcomes, but with significantly increased toxicity. Compared to 3DCRT, the introduction of IMRT resulted in a significant reduction of acute and late toxicity with slightly better, or at least comparable, outcomes. Despite the improvements achieved by the implementation of chemo-IMRT, different new strategies to further improve outcome and reduce toxicity need to be thoroughly investigated in prospective, preferably, randomized trials.
机译：目的/假设：研究治疗方式和放射技术对局部晚期口咽癌（OPC）患者的肿瘤学结局和毒性的影响。研究设计：回顾性分析结果和毒性。方法：在2000年至2011年之间，对连续204例局部晚期OPC患者进行了3维保形（3DCRT）或强度调制放疗（IMRT）的确定性（化学）放疗。终点是局部控制（LC），区域控制（RC），无病生存期（DFS），特定原因生存期（CSS），总生存期（OS）和毒性。结果：经过44个月的中位随访（范围4-134），对LC，RC，DFS，CSS和OS的5年Kaplan-Meier估计分别为78％，92％，60％，64％，和48％。据报道3级粘膜炎和吞咽困难（进食管依赖性）分别为75％和65％。 ≥2级和3级晚期毒性的总发生率分别为44％和16％。吞咽困难和口干症是最常报告的晚期毒性。化学疗法可显着预测改善结果和增加毒性。 IMRT与毒性降低显着相关。结论：与单独放疗相比，放化疗治疗显着改善了肿瘤学结局，但毒性显着增加。与3DCRT相比，IMRT的引入可显着降低急性和晚期毒性，并具有稍好或至少可比的结果。尽管通过化学IMRT的实施实现了改善，但仍需要在前瞻性（最好是随机试验）中彻底研究进一步改善疗效和降低毒性的不同新策略。

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