Tumor volume reduction rate measured during adaptive definitive radiation therapy as a potential prognosticator of locoregional control in patients with oropharyngeal cancer.

Head & Neck Pub Date : 2014-04-01 Epub Date: 2013-06-18 DOI:10.1002/hed.23328
Hyebin Lee, Yong Chan Ahn, Dongryul Oh, Heerim Nam, Young Il Kim, Su Yeon Park
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引用次数: 29

Abstract

Background: The purpose of this study was to evaluate the prognostic significance of the tumor volume reduction rate (TVRR) measured during adaptive definitive radiation therapy (RT) in patients with oropharyngeal cancer.

Methods: We reviewed the RT records of 59 patients with oropharyngeal cancer who were treated with definitive RT with or without concurrent chemotherapy between January 2006 and October 2010. Adaptive replanning was performed in all patients during RT. The pre-RT and mid-RT gross tumor volumes (GTVs) of the primary and the metastatic lymph nodes were measured and analyzed for their possible impacts on locoregional control.

Results: After the median follow-up period of 41.3 months (range, 9.3-73.5 months) for survivors, there were 10 treatment failures (8 locoregional recurrences and 2 distant metastases). The locoregional control rate at 3 years in all the patients was 84.1%. The mean pre-RT and mid-RT total GTVs were 27.5 cm(3) (±17.9 cm(3) ) and 16.9 cm(3) (±12.1 cm(3) ), and the mean GTV reduction rate was 37.9% (±22.6%), respectively. The patients who achieved locoregional control had a higher TVRR than those with locoregional failure (p = .010), and those with the TVRR >35% achieved significantly higher locoregional control at 3 years (94.4% vs 72.4%; p = .018). On multivariate analysis when adjusted with other clinical prognostic factors, the TVRR was found to be a significant factor affecting the locoregional control (hazard ratio = 0.136; 95% confidence interval = 0.022-0.852; p = .033).

Conclusion: The TVRR measured during adaptive RT proved a significant prognosticator on locoregional disease control in patients with oropharyngeal cancer, based on which a few therapeutic modifications may be considered.

在口咽癌患者的适应性确定放射治疗期间测量肿瘤体积缩小率作为局部区域控制的潜在预后指标。
背景:本研究的目的是评估口咽癌患者在适应性终期放射治疗(RT)期间肿瘤体积缩小率(TVRR)测量的预后意义。方法:我们回顾了2006年1月至2010年10月间59例口咽癌患者的放射治疗记录,这些患者接受了明确的放射治疗并伴有或不伴有化疗。所有患者在放疗期间都进行了适应性重新规划。测量了原发淋巴结和转移淋巴结的术前和中期总肿瘤体积(gtv),并分析了它们对局部区域控制的可能影响。结果:幸存者中位随访期41.3个月(9.3-73.5个月),治疗失败10例(局部复发8例,远处转移2例)。所有患者3年局部控制率为84.1%。平均放疗前和放疗中总GTV为27.5 cm(3)(±17.9 cm(3))和16.9 cm(3)(±12.1 cm(3)),平均GTV降低率分别为37.9%(±22.6%)。获得局部区域控制的患者TVRR高于局部区域失败的患者(p = 0.010), TVRR >35%的患者在3年时获得了显著更高的局部区域控制(94.4% vs 72.4%;P = .018)。在多因素分析中,当与其他临床预后因素进行校正时,发现TVRR是影响局部区域控制的重要因素(风险比= 0.136;95%置信区间= 0.022-0.852;P = .033)。结论:适应性放疗中TVRR的测量对口咽癌患者局部疾病控制有重要的预测作用,在此基础上可以考虑一些治疗修改。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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