一项随机前瞻性研究,比较了局部晚期头颈癌同步综合放疗和连续调强放疗的急性毒性、依从性和客观反应率。

IF 1.8 Q3 ONCOLOGY
Radiation Oncology Journal Pub Date : 2021-03-01 Epub Date: 2021-03-18 DOI:10.3857/roj.2020.01018
Akanksha Grover, Tej Prakash Soni, Nidhi Patni, Dinesh Kumar Singh, Naresh Jakhotia, Anil Kumar Gupta, Lalit Mohan Sharma, Shantanu Sharma, Ravindra Singh Gothwal
{"title":"一项随机前瞻性研究,比较了局部晚期头颈癌同步综合放疗和连续调强放疗的急性毒性、依从性和客观反应率。","authors":"Akanksha Grover, Tej Prakash Soni, Nidhi Patni, Dinesh Kumar Singh, Naresh Jakhotia, Anil Kumar Gupta, Lalit Mohan Sharma, Shantanu Sharma, Ravindra Singh Gothwal","doi":"10.3857/roj.2020.01018","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Intensity-modulated radiotherapy (IMRT) provides higher dose to target volumes and limits the dose to normal tissues. IMRT may be applied using either simultaneous integrated boost (SIB-IMRT) or sequential boost (SEQ-IMRT) technique. The objectives of this study were to compare acute toxicity and objective response rates between SIB-IMRT and SEQ-IMRT in patients with locally advanced head and neck cancer.</p><p><strong>Materials and methods: </strong>Total 110 patients with locally advanced carcinoma of oropharynx, hypopharynx, and larynx were randomized equally into the two arms (SIB-IMRT vs. SEQ-IMRT). Patients in SIB-IMRT arm received dose of 66 Gy in 30 fractions, 5 days a week, over 6 weeks. SEQ-IMRT arm's patients received 70 Gy in 35 fractions over 7 weeks. Weekly concurrent cisplatin chemotherapy was given in both arms. Patients were assessed for acute toxicities during the treatment and for objective response at 3 months after the radiotherapy.</p><p><strong>Results: </strong>Grade 3 dysphagia was significantly more with SIB-IMRT compared to SEQ-IMRT (72% vs. 41.2%; p = 0.006) but other toxicities including mucositis, dermatitis, xerostomia, weight-loss, incidence of nasogastric tube intubation and hospitalization for supportive management were similar in both the arms. Patients in SIB-IMRT arm showed better treatment-compliance and had significantly less treatment-interruption compared to SEQ-IMRT arm (p = 0.028). Objective response rates were similar in both the arms (p = 0.783).</p><p><strong>Conclusion: </strong>Concurrent chemoradiation with SIB-IMRT for locally advanced head and neck cancer is well-tolerated and results in better treatment-compliance, similar objective response rates, comparable incidence of mucositis and higher incidence of grade 3 dysphagia compared to SEQ-IMRT.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/cf/roj-2020-01018.PMC8024186.pdf","citationCount":"0","resultStr":"{\"title\":\"A randomized prospective study comparing acute toxicity, compliance and objective response rate between simultaneous integrated boost and sequential intensity-modulated radiotherapy for locally advanced head and neck cancer.\",\"authors\":\"Akanksha Grover, Tej Prakash Soni, Nidhi Patni, Dinesh Kumar Singh, Naresh Jakhotia, Anil Kumar Gupta, Lalit Mohan Sharma, Shantanu Sharma, Ravindra Singh Gothwal\",\"doi\":\"10.3857/roj.2020.01018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Intensity-modulated radiotherapy (IMRT) provides higher dose to target volumes and limits the dose to normal tissues. IMRT may be applied using either simultaneous integrated boost (SIB-IMRT) or sequential boost (SEQ-IMRT) technique. The objectives of this study were to compare acute toxicity and objective response rates between SIB-IMRT and SEQ-IMRT in patients with locally advanced head and neck cancer.</p><p><strong>Materials and methods: </strong>Total 110 patients with locally advanced carcinoma of oropharynx, hypopharynx, and larynx were randomized equally into the two arms (SIB-IMRT vs. SEQ-IMRT). Patients in SIB-IMRT arm received dose of 66 Gy in 30 fractions, 5 days a week, over 6 weeks. SEQ-IMRT arm's patients received 70 Gy in 35 fractions over 7 weeks. Weekly concurrent cisplatin chemotherapy was given in both arms. Patients were assessed for acute toxicities during the treatment and for objective response at 3 months after the radiotherapy.</p><p><strong>Results: </strong>Grade 3 dysphagia was significantly more with SIB-IMRT compared to SEQ-IMRT (72% vs. 41.2%; p = 0.006) but other toxicities including mucositis, dermatitis, xerostomia, weight-loss, incidence of nasogastric tube intubation and hospitalization for supportive management were similar in both the arms. Patients in SIB-IMRT arm showed better treatment-compliance and had significantly less treatment-interruption compared to SEQ-IMRT arm (p = 0.028). Objective response rates were similar in both the arms (p = 0.783).</p><p><strong>Conclusion: </strong>Concurrent chemoradiation with SIB-IMRT for locally advanced head and neck cancer is well-tolerated and results in better treatment-compliance, similar objective response rates, comparable incidence of mucositis and higher incidence of grade 3 dysphagia compared to SEQ-IMRT.</p>\",\"PeriodicalId\":46572,\"journal\":{\"name\":\"Radiation Oncology Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2021-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/cf/roj-2020-01018.PMC8024186.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiation Oncology Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3857/roj.2020.01018\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/3/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiation Oncology Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3857/roj.2020.01018","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/3/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:调强放射治疗(IMRT)可为靶体积提供更高的剂量,并限制正常组织所受的剂量。IMRT 可采用同步综合增强(SIB-IMRT)或顺序增强(SEQ-IMRT)技术。本研究的目的是比较SIB-IMRT和SEQ-IMRT在局部晚期头颈癌患者中的急性毒性和客观反应率:110例口咽、下咽和喉局部晚期癌症患者被随机平均分为两组(SIB-IMRT与SEQ-IMRT)。SIB-IMRT治疗组的患者接受66Gy的剂量,分30次进行,每周5天,持续6周。SEQ-IMRT治疗组患者在7周内接受70Gy,分35次进行。两组患者同时接受每周一次的顺铂化疗。对患者在治疗期间的急性毒性和放疗后3个月的客观反应进行评估:结果:与SEQ-IMRT相比,SIB-IMRT患者出现3级吞咽困难的比例明显更高(72% vs. 41.2%; p = 0.006),但两组患者的其他毒性反应(包括粘膜炎、皮炎、口角炎、体重减轻、鼻胃管插管和住院支持治疗的发生率)相似。与 SEQ-IMRT 治疗组相比,SIB-IMRT 治疗组患者的治疗依从性更好,治疗中断的情况也明显减少(p = 0.028)。两组患者的客观反应率相似(p = 0.783):结论:与 SEQ-IMRT 相比,SIB-IMRT 同时化疗治疗局部晚期头颈癌的耐受性良好,治疗依从性更好,客观反应率相似,粘膜炎发生率相当,3 级吞咽困难发生率更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A randomized prospective study comparing acute toxicity, compliance and objective response rate between simultaneous integrated boost and sequential intensity-modulated radiotherapy for locally advanced head and neck cancer.

A randomized prospective study comparing acute toxicity, compliance and objective response rate between simultaneous integrated boost and sequential intensity-modulated radiotherapy for locally advanced head and neck cancer.

Purpose: Intensity-modulated radiotherapy (IMRT) provides higher dose to target volumes and limits the dose to normal tissues. IMRT may be applied using either simultaneous integrated boost (SIB-IMRT) or sequential boost (SEQ-IMRT) technique. The objectives of this study were to compare acute toxicity and objective response rates between SIB-IMRT and SEQ-IMRT in patients with locally advanced head and neck cancer.

Materials and methods: Total 110 patients with locally advanced carcinoma of oropharynx, hypopharynx, and larynx were randomized equally into the two arms (SIB-IMRT vs. SEQ-IMRT). Patients in SIB-IMRT arm received dose of 66 Gy in 30 fractions, 5 days a week, over 6 weeks. SEQ-IMRT arm's patients received 70 Gy in 35 fractions over 7 weeks. Weekly concurrent cisplatin chemotherapy was given in both arms. Patients were assessed for acute toxicities during the treatment and for objective response at 3 months after the radiotherapy.

Results: Grade 3 dysphagia was significantly more with SIB-IMRT compared to SEQ-IMRT (72% vs. 41.2%; p = 0.006) but other toxicities including mucositis, dermatitis, xerostomia, weight-loss, incidence of nasogastric tube intubation and hospitalization for supportive management were similar in both the arms. Patients in SIB-IMRT arm showed better treatment-compliance and had significantly less treatment-interruption compared to SEQ-IMRT arm (p = 0.028). Objective response rates were similar in both the arms (p = 0.783).

Conclusion: Concurrent chemoradiation with SIB-IMRT for locally advanced head and neck cancer is well-tolerated and results in better treatment-compliance, similar objective response rates, comparable incidence of mucositis and higher incidence of grade 3 dysphagia compared to SEQ-IMRT.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.50
自引率
4.30%
发文量
24
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信