Postoperative Intensity Modulated Radiation Therapy in Oral Cavity Cancer

術後強度調控式放射線治療於口腔癌之應用

劉士華(Shih-Hua Liu) ； 陳裕仁(Yu-Jen Chen)

《中華民國癌症醫學會雜誌》 25卷1期 (2009/02) Pp. 12-19

https://doi.org/10.6588/JCOS.2009.25.1.2

摘要

主題：強度調控式放射線治療於頭頸部癌症的治療已被廣泛的使用。由於強度調控式放射線治療可以提高劑量分布的順形性，使得腫瘤體積內得到充足的放射線劑量並進而減少因放射線治療所引起的毒性反應，所以可達到提高腫瘤控制率和降低正常組織併發症的目的。目前強度調控式放射線治療多應用在沒有切除的頭頸部癌症上；反之，在手術後輔助性治療的運用則較少被探討。口腔癌病患多先接受手術切除，放射線治療的角色則以術後輔助性的型態較多。此篇文章回顧了近年來於口腔癌病患接受術後強度調控式放射線治療的應用，包括治療區域的擬定、劑量的給予、及治療後局部復發的形式，以期能幫助臨床上更多運用。

關鍵字

強度調控式放射線治療 ； 口腔癌 ； 手術後放射線治療

並列摘要

Intensity-modulated radiation therapy (IMRT) has been widely accepted for treatment of head-and-neck cancers (HNC). The higher conformality of dose distribution produced by IMRT allows tight dose gradients around the target and sharp fall-off near the boundaries. Thus, we can deliver higher dose to the tumor or risky target without increase, or even with decrease, in dose distributed to normal tissues. This may result in improvement of local control as well as reduction of normal tissue damage. However, most published studies of IMRT have focused on treating diseases with gross tumor, resulting in a lack of consensus regarding use of postoperative IMRT for HNC. This unmet need for HNC is of great importance for oral cavity cancers because surgery remains the mainstay treatment. This article reviews the issues in target selection and delineation, dose specification, and the patterns of failure from published reports for postoperative IMRT in oral cavity cancers. We have attempted to provide more and detailed information as a reference for daily practice of treating physicians.

並列關鍵字

Oral cavity cancer ； IMRT ； Postoperative radiotherapy