Ayşe HİÇSÖNMEZ, Yıldız GÜNEY, Ayşen DİZMAN, Nalça ANDRIEU MELTEM

Epidermoid Baş-Boyun Kanserlerinin Tedavisinde Hiperfraksiyone Radyoterapi Sonuçları

Amaç: Çalışmamızda epidermoid başboyun kanserlerinde Hiperfraksiyone Radyoterapi (HFRT)’nin lokal-bölgesel kontrole olan etkilerini, akut ve geç yan etkiler açısından tedavinin hastalar tarafından ne derece tolere edilebileceğinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Mart 1995-Şubat 1996 arasında, baş-boyunun çeşitli bölgelerinden (Nazofarenks, Larenks, Oral kavite, Maksiler sinüs) orjin alan 30 epidermoid karsinomlu hasta HFRT küratif RT protokolüne dahil edildi. 25 hasta değerlendirmeye alındı. Yaşları 15-80 arasındaydı ( ortalama yaş 45.5). Primer tümör ve üst boyun bölgesi 1.2 Gy/fraksiyon (frk) 6 saat ara ile günde iki defa tedavi edildi. Total tedavi dozu 60-74.4 Gy arasında idi. Sonuç: Hastalar minimum ay, maksimum 9 ay takip edildi. 18 hastada servikal lenfatik tutulum vardı (N+). 18 hasta evre IV, 4 hasta evre III, 2 hasta evre II, 1 hastada evre I’di. % 56 (14 hasta) hastada lokal bölgesel tam cevap sağlandı. Primer tümör (lokal) komplet cevap oranı % 56’dır. Tutulmuş servikal lenfatiklerin (bölgesel) komplet cevap oranı % 83’dür. Bölgesel cevap primer cevaba oranla daha yüksek oranda sağlandı. %40 (10 hasta) hastada parsiyel cevap alındı. Hastalarda verilen doz ile lokal kontrol arasında bir ilişki görülmedi. Tedavi hastalar tarafından iyi tolere edildi. Hiçbir hastada grade 4 toksisite görülmedi. Akut reaksiyonlar ile tedaviye ara verilme oranı % 28’dir. Takip süresi içinde % 36 oranında grade 1 geç radyasyon ödemi, hastaların % 24’ünde grade 3 ağız kuruluğu ve tad kaybı, % 8 hastada grade 1 disfaji gözlendi

Anahtar Kelimeler:

Hiperfraksiyone, Radyoterapi, Baş-boyun kanserleri

Purpose: The optimal fractionation schedule for radiotherapy of head and neck cancer has been controversial. The objective of this study was to test the efficacy of hyperfractionation radiotherapy on patients with head and neck cancer. Methods and Materials: Between March 1995- February 1996, 30 patients with head and neck tumors (Nasopharynx, oral cavity, larynx and maksiler sinus) were treated hyperfraction radiotherapy. 25 patients were evaluated. The mean age was 45.5. Fractions used were 1.2 Gy twice-a-day with a curative intent on all patients, to a total mean dose 6074.4 Gy. Results: With a follow-up of min 2 months-9 months. 18 patients had cervical lymphadenopaty (N+). The number of of patients at each clinical stage were as follows: stage IV ,18; stage III, 4; stage II, 2; Stage I, 1. Loca-regional complete response was observed in % 56 (14 patients). Local complet response rate was % 56, regional complete response rate was % 83. Regional response rate was higher than local response rate. %40 (10 patients) had parsiyal response. No relations was observed between dose and local control rate. No patients had grade 4 toxicity. % 28 patients had require treatment interuptions due to acute reactions. Severe late toxicity was not observed ( %36 grade 1 larynx eudema, % 24 grade 3 xerostomia, % 8 grade 1 disphaji). Conclusion: Our data indicates that hyperfractionation radiotherapy for head and neck cancer is both feasible and effective, with acceptable toxicities. Key Words: Hyperfractionation, radiotherapy, head-neck cancer

Keywords:

Hyperfractionation, radiotherapy, head-neck cancer,

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