| 高晶,孔琳,管西寅,胡集祎,张晓斐,朱颖超,陆嘉德.质子碳离子治疗腺样囊性癌的近期疗效及不良反应[J].中华放射医学与防护杂志,2016,36(8):607-610 |
| 质子碳离子治疗腺样囊性癌的近期疗效及不良反应 |
| Early response and acute adverse effect after particle radiation therapy for adenoid cystic carcinoma of the head and neck |
| 投稿时间：2016-03-27 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.08.010 |
| 中文关键词: 头颈部腺样囊性癌 质子 重离子 放射治疗 |
| 英文关键词:Head and neck ACC Proton Heavy ion Radiation therapy |
| 基金项目:上海市科学技术委员会科研项目(15411950102) |
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| 中文摘要: |
| 目的 观察束流调强粒子放射治疗头颈部腺样囊性癌的不良反应和近期疗效。方法 2015年5月至2016年3月，8例初治的病理证实的头颈部腺样囊性癌患者，5例患者为局部晚期（T3-4期），3例患者为R1切除，5例患者为活检术后或R2切除。7例患者采用束流调强质子放射治疗（IMPT）联合束流调强碳离子放射治疗（IMCT），IMPT放射临床靶区体积（CTV）56 GyE/28次后，采用IMCT给予局部加量治疗15 GyE/5次。1例患者接受了单纯的IMPT治疗。结果 根据新版实体瘤疗效评价标准（RECIST）评估标准，本组5例具有明确肿瘤病灶的患者，在放疗结束时和结束后1个月，3例肿瘤部分缓解（PR），2例疾病稳定（SD）；4例放疗结束后3个月随访时，有2例达到完全缓解（CR），1例PR，1例SD。至2016年3月所有患者均无肿瘤进展和死亡。放疗期间，2例发生了3级口腔黏膜反应，随访3个月无重度皮肤反应发生。结论 束流调强粒子放射治疗头颈部腺样囊性癌安全、有效，但后期不良反应和远期疗效尚需更长时间的观察。 |
| 英文摘要: |
| Objective To study the early response and acute/subacute adverse effects after particle radiation therapy for adenoid cystic carcinoma (ACC) of the head and neck. Methods Between May 2015 and March 2016, a total of 8 patients with ACC of the head and neck were treated using proton and/or carbon-ion radiation therapy. Three patients had early stage and 5 had locally advanced disease. Five patients had an R2 and three achieved an R1 resection. Results Seven patients received intensity-modulated proton therapy (IMPT) followed by intensity-modulated carbon-ion therapy (IMCT) boost. One patient received IMPT only. Among the five patients who had an R2 resection, 2/3 patients had partial response (PR)/stable disease (SD) at the end of radiation, 0/3 achieved PR/complete response (CR) at 1-month follow-up, and 1/2 achieved PR/CR at 3-months' follow-up after the completion of radiation, respectively. Two patients experienced Grade Ⅲ mucositis during radiation therapy. No patient experienced moderate or severe skin reactions. At the time of this analysis, all patients are alive and no patient had disease progression or recurrence. Conclusions The short-term outcomes indicated that particle therapy is safe and potentially efficacious in the management of head and neck ACC. However, longer follow up is needed to assess late toxicities and long-term efficacy. |
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