复发头颈部癌再程放疗研究  

The study of re-irradiation for head and neck cancer

作　　者：陆雪官[1] 胡超苏[1] Lu Xuegua Hu Chaosu(Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai 200032, Chin)

机构地区：[1]复旦大学附属肿瘤医院放疗中心,上海200032

出　　处：《中华放射肿瘤学杂志》2017年第7期723-727,共5页Chinese Journal of Radiation Oncology

摘　　要：近50%的头颈部癌病例在接受首程放疗后会出现放射野内复发.挽救性手术是首选的治疗手段.临床研究表明复发头颈部癌接受挽救性手术＋术后再程放疗或者再程放疗＆#177;化疗或靶向药物治疗后能使一小部分病例获益,得到肿瘤控制和长期生存.但总体疗效不尽如人意,且伴发严重的急性和晚期,甚至致死性的治疗相关不良反应.因此要求在实施再程放疗时需要充分考虑复发肿瘤情况、首次放疗相关因素和病人自身状态.随着放疗技术和综合治疗模式的发展,包括质子和重离子以及免疫治疗的临床应用,为提高复发头颈部癌治疗疗效,降低治疗相关不良反应提供了可能性.Nearly 50% patients with head and neck cancer after radiotherapy will recurrence in the previous radiation fields.Salvage surgery is the first choice of treatment.Clinical studies have shown that a small number of patients with recurrent head and neck cancer can benefit from salvage surgery plus postoperative re-irradiation or re-irradiation with or without chemotherapy or targeted therapy,and these patients can achieved tumor control and long-term survival.However, the overall efficacy is not satisfactory, and often accompanied by severe acute and late, and even fatal treatment-related toxicity.Therefore, it is necessary to give full consideration to the condition of recurrent tumor, the first radiotherapy related factors and the patient′s related status before implementation of re-irradiation.The development of radiotherapy technology and comprehensive treatment, including the clinical application of proton and heavy ion and immune therapy, provides the possibility of improving the prognosis and reducing treatment-related toxicity for these patients.

关 键 词：肿瘤复发 头颈部 再程放射疗法 

分 类 号：R730.55[医药卫生—肿瘤] R739.91[医药卫生—临床医学]