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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Dose to the inferior pharyngeal constrictor predicts prolonged gastrostomy tube dependence with concurrent intensity-modulated radiation therapy and chemotherapy for locally-advanced head and neck cancer
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Dose to the inferior pharyngeal constrictor predicts prolonged gastrostomy tube dependence with concurrent intensity-modulated radiation therapy and chemotherapy for locally-advanced head and neck cancer

机译：下咽缩管的剂量可预测胃造口管的长期依赖性，同时进行强度调制放疗和化疗可治疗局部晚期头颈癌

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Background and purpose To determine if dose and/or dose-volume parameters to anatomic swallowing structures are predictive of gastrostomy tube (PEG) dependence from chemotherapy-intensity modulated radiotherapy (IMRT) in locally advanced head and neck cancer (LAHNC). Methods and materials A retrospective study was performed on 141 consecutive patients with LAHNC (squamous cell) treated with definitive chemoIMRT with weekly concurrent carboplatin and paclitaxel. Late dysphagia was assessed by length of PEG requirement. Analysis of IMRT dose was retrospectively performed for critical swallowing structures. Results Approximately 62% of patients required PEG, the majority placed during treatment. Mean and median time for PEG was 7.7 and 4.4 months respectively (range 1.4-43.8). Only IMRT dose to the inferior constrictor was significantly associated with length of PEG. Mean dose (of individual mean doses) was 47 Gy for prolonged PEG use versus 41 Gy for PEG ≤12 months. V40 to the inferior constrictor also correlated with PEG 12 months (p = 0.02) with a mean V40 of 48% versus 41% for PEG ≤12 months. Conclusions IMRT dose to the inferior constrictor correlated with persistent dysphagia requiring prolonged PEG use. Maintaining mean inferior constrictor dose to ≤41 Gy and V40 to ≤41% may help minimize gastrostomy tube dependence.
机译：背景和目的为了确定局部吞咽解剖结构的剂量和/或剂量体积参数是否可预测局部晚期头颈癌（LAHNC）的化疗强度调制放疗（IMRT）对胃造口管（PEG）的依赖性。方法和材料回顾性研究连续141例LAHNC（鳞状细胞）患者，接受定性chemoIMRT联合每周卡铂和紫杉醇治疗。晚期吞咽困难是通过PEG需要量来评估的。回顾性分析了关键吞咽结构的IMRT剂量。结果约有62％的患者需要PEG，大多数患者在治疗期间放置。 PEG的平均时间和中位数时间分别为7.7和4.4个月（范围1.4-43.8）。仅对下to缩管的IMRT剂量与PEG的长度显着相关。延长的PEG使用的平均剂量（单个平均剂量）为47 Gy，而≤12个月的PEG为41 Gy。下缩血管的V40也与PEG> 12个月相关（p = 0.02），平均V40为48％，而≤12个月的PEG为41％。结论IMRT对下颈缩的剂量与持续吞咽困难有关，需要长期使用PEG。维持平均下缩窄剂量至≤41Gy和V40至≤41％可能有助于最大程度地降低胃造口管的依赖性。

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