射波刀立体定向放射治疗技术在复发头颈部肿瘤再程放射治疗中的应用

Application of CyberKnife stereotactic radiosurgery technique in re-radiotherapy on recurrent tumor of head and neck

目的:评估射波刀立体定向放射治疗技术在复发头颈部肿瘤再程放射治疗中的临床效果及安全性。方法:选取医院收治的57例复发头颈部肿瘤患者,均接受射波刀立体定向放射治疗并进行随访,评估治疗后疼痛缓解率、生活质量改善率、治疗有效率、1年局部控制率、无进展生存时间、1年生存率及治疗后不良反应。结果:57例患者治疗1个月后,疼痛缓解率为90%,生活质量改善率为84.2%,治疗有效率为82.5%,临床获益率100%,1年局部控制率78.9%,中位无进展生存时间10.6个月,1年生存率62.0%,患者治疗期间的急性不良反应为乏力和局部疼痛,治疗结束后均逐渐减轻或消失,未出现急性黏膜炎。治疗后不良反应为口咽黏膜炎及吞咽不适,多数为1~2级,无3级以上不良反应。结论:射波刀立体定向放射治疗技术再程放射治疗复发头颈部肿瘤能较快减轻患者症状,不良反应小,安全性高。

Objective:To assess the clinical effect and safety of Cyberknife stereotactic radiotherapy technique in the re-radiotherapy on recurrent tumor of head and neck.Methods:A total of 57 patients with recurrent tumor of head and neck who admitted to hospital were selected,and all of them received Cyberknife stereotactic radiotherapy and follow-up.The remission rate of pain,the improvement rate of living quality,the effective rate of treatment,the rate of local control within 1-year,the survival time of progression-free,the survival rate within 1 year and adverse reaction of this treatment were assessed.Results:After 1 months of treatment for 57 patients,the remission rate of pain was 90%,and the improvement rate of living quality was 84.2%,and the effective rate of treatment was 82.5%,and the rate of obtaining benefit was 100%,the rate of local control within 1 year was 78.9%,the median of survival time of progression-free was 10.6 months,and the survival rate within 1 year was 62.0%.During treatment,the acute adverse reactions of patients included weak and local pain.After they completed treatment,the acute adverse reactions gradually were relieved or eliminated,and the acute mucositis did not occur in them.After treatment,the adverse reactions included oral mucositis and swallowing discomfort,and most of them was grade I-II,and the adverse reaction above grade III did not exist.Conclusion:Cyberknife stereotactic radiotherapy technique can faster relieve the symptoms of patients with recurrent tumor in head and neck,which has less adverse reaction and higher safety.