质子治疗头颈部复发腺样囊性癌的初步观察

Preliminary clinical experience of proton therapy for head and neck recurrent adenoid cystic carcinoma

目的初步评估质子治疗头颈部复发的腺样囊性癌(ACC)的疗效和不良反应。方法2005-2010年间我院质子中心共收治了6例病理证实的局部复发的头颈部ACC患者,均给予质子适形照射,剂量54.0~77.5Gy(中位数64Gy)分27~37次,2.0~2.5Gy/次。结果6例患者均顺利完成质子治疗。总缓解4/6。1、3、5年总生存分别为6/6、5/6、2/6。急性不良反应为6/6,口腔黏膜反应为2/6。晚期不良反应中脑坏死为1/6,失明为2/6。结论质子治疗头颈部腺样囊性癌初步显示安全有效。

Objective To preliminary evaluate the efficacy and toxicities inpatients with head and neck recurrent adenoid cystic carcinoma(ACC)treated with proton therapy.Methods From December 2005 to April 2010,6 patients with head and neck recurrent ACC were treated with proton therapy.All patients received proton conformal radiotherapy,the total dose was 54.0-77.5 Gy/27-37 fractions(2.0-2.5 Gy/fraction).Results All of patients successfully completed proton therapy.The overall response rate was 66.7%.The 1-,3-and 5-years overall survival was 5/6 and 2/6,respectively.The incidence of acute radiation injury included dermatitis in all patients and oral mucositis in 2/6 patients.The incidence of late toxicity included 1/6 of patients developed brain necrosis and 2/6 of patients developed optic nerve injury with complete blindness.Conclusion Proton therapy is safe and effective in the treatment of head and neck ACC.