Definitive Radiotherapy with or Without Chemotherapy for Resectable Head and Neck Cancer

使用放射治療或合併化學治療之方式治療可切除之頭頸部腫瘤

成佳憲(Jason Chia-Hsien Cheng) ； 鄭鴻鈞(Skye Hongiun Cheng) ； 簡哲民(James Jer-Min Jian) ； 閻愷正(Lawrence K. Yen) ； 詹光裕(Kwan-Yee Chan) ； 謝政毅(Cheng-I Hsieh)

《放射治療與腫瘤學》 6卷1期 (1999/03) Pp. 33-39

https://doi.org/10.6316/TRO/199906(1)33

摘要

目的：回顧性分析以放射治療或合併化學治療之方式治療可切除之頭頸部腫瘤的可行性、治療副作用及存活率。
材料與方法：三十位診斷為可切除之頭頸部腫瘤病人接受根治性放射治療或合併化學治療。一位病人為第一期，四位第二期，三位第三期，二十二位第四期疾病。放射治療為一日一次或一日兩次，總劑量為68-74Gy。化學治療使用CDDP與5-FU，包括兩次放射治療中的合併治療，與兩次放射治療後的治療。以 Kaplan-Meier method分析存活率，以log-rank test分析預後因子。
結果：追蹤時間之中位數為50.8個月。四年整體存活率、無病存活率及局部控制率分別為55.7%、64.9%及75.8%。治療相關的副作用屬可忍受。Tl/T2腫瘤的病人在統計上具有意義的較佳局部控制率(p=0.03)。治療結束後的核磁共振或電腦斷層檢查中若有殘存疾病的病人，具統計上有意義的較差整體存活率(p=0.05)、無病存活率(p＝0.009)及局部無再發存活率(p＝0.0001)。
結論：放射治療或合併化學治療之方式治療可切除之頭頸部腫瘤可考慮為根除手術外的一種選擇。它具有可接受的治療相關副作用及存活率。治療結束後的核磁共振或電腦斷層檢查中若有殘存疾病的病人，應接受進一步探查與治療。

關鍵字

可切除之頭頸部腫瘤 ； 放射治療 ； 化學治療 ； 合併治療

並列摘要

Purpose: To retrospectively analyze the feasibility, toxicity and outcome of definitive radiotherapy with or without chemotherapy for patients with resectable head and neck cancers.
Materials and Methods: Thirty patients with resectable head and neck cancers were treated with definitive split-course radiotherapy with or without concurrent chemotherapy. One patient had stage I, 4 stage II, 3 stage Ⅲ and 22 stage IV diseases. Radiotherapy was given once daily or twice daily with total dose of 68-74 Gy. Chemotherapy included 2 cycles with CDDP+/-SFIJ during radiotherapy, and 2 cycles with CDDP+5FU after radiation treatment. Survival outcome was calculated by the Kaplan-Meier method. Prognostic factors were determined by log-rank test.
Results: The median follow-up time was 50.8 months. The 4-year overall survival, disease-free survival and locoregional control rates were 55.7%, 64.9% and 75.8%, respectively. Treatment-related toxicities were tolerable. T1/T2 diseases were associated with heifer locoregional control (p=0.03). The presence of residual disease on post-treatment MRI or CT was the prognostic factor for overall survival (p=0.05), disease-free survival (p=0.009) and locoregional recurrence-free survival (p=0.0001).
Conclusion: Definitive radiotherapy with or without chemotherapy can be an alternative to radical surgery for patients with resectable head and neck cancers, with acceptable toxicity and outcome. The presence of residual disease on post-treatment imaging studies demands further investigation and possibly salvage treatment.

並列關鍵字

Resectable head and neck cancers ； Radiotherapy ； Chemotherapy ； Concurrent