[頭頸癌] 術後同步化放療論文整理

提到頭頸癌術後同步化放療, 就一定要提到兩篇文章, 分別是 EORTC 22931 和 RTOG9501

1. EORTC 22931: 頭頸癌開過刀(收案條件: pT3-4, pT1-2N2-3, oral cavity/oropharynx with levels IV/V LN involved, or T1-2N0-1 with ECE, margin+, LVI, or PNI ), 分成兩組, 一組接受放射治療(66Gy/33Fr)+化療(cisplatin 100mg/m^2 on days 1,22,43),另一組只接受放射治療(66Gy/33Fr), 結果為同步化放療組有比較好的OS, DFS, 5-yr local regional control, 但是grade 3,4 副作用比較多

2. RTOG9501: 頭頸癌開過刀(收案條件: ≥ 2 LNs, ECE, margin+),  分成兩組, 一組接受放射治療(60-66Gy in 2Gy/1Fr)+化療(cisplatin 100mg/m^2 on days 1,22,43),另一組只接受放射治療(60-66Gy in 2Gy/1Fr), 其結果為同步化放療組在DFS和2-yr local regional control比較好, 但是OS並沒有統計上差異; 後來在Red journal 有發表一篇長期追蹤的結果, 發現只有在ECE or margin positive 有 10yr-LRC的好處, 10yr-OS只有trend(p=0.07)

3. Bernier(2005): 這個作者把上面兩篇EORTC和RTOG9501做整合, 發現只有ECE and/or margin+的情況下, post-OP CRT 和 RT 相比可以改善 OS, DFS, LRC


reference:
1. Bernier, Jacques, et al. "Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer." New England Journal of Medicine 350.19 (2004): 1945-1952.

2. Cooper, Jay S., et al. "Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck." New England Journal of Medicine 350.19 (2004): 1937-1944.

3. Cooper, Jay S., et al. "Long-term follow-up of the RTOG 9501/intergroup phase III trial: postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the head and neck." International Journal of Radiation Oncology* Biology* Physics 84.5 (2012): 1198-1205.

4. Bernier, Jacques, et al. "Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (# 22931) and RTOG (# 9501)." Head & Neck: Journal for the Sciences and Specialties of the Head and Neck 27.10 (2005): 843-850.

5. Handbook of evidence-based radiation oncology 3rd edition