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Titolo:
Treatment of early and moderately advanced vocal cord carcinoma with 6-MV X-rays
Autore:
Parsons, JT; Greene, BD; Speer, TW; Kirkpatrick, SA; Barhorst, DB; Yanckowitz, T;
Indirizzi:
Bethesda Mem Hosp, Ctr Radiat Oncol, Boynton Beach, FL 33435 USA Bethesda Mem Hosp Boynton Beach FL USA 33435 Boynton Beach, FL 33435 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 4, volume: 50, anno: 2001,
pagine: 953 - 959
SICI:
0360-3016(20010715)50:4<953:TOEAMA>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
SQUAMOUS-CELL CARCINOMA; EARLY GLOTTIC CANCER; INFLUENCING LOCAL-CONTROL; RADIATION-THERAPY; PROGNOSTIC FACTORS; MULTIVARIATE-ANALYSIS; TREATMENT TIME; FRACTION SIZE; STAGE-II; PRETREATMENT HEMOGLOBIN;
Keywords:
T1 glottic cancer; T2 glottic cancer; radiation therapy; 6 MV X-rays; time-dose parameters;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
68
Recensione:
Indirizzi per estratti:
Indirizzo: Parsons, JT Bethesda Mem Hosp, Ctr Radiat Oncol, 2815 S Seacrest Blvd, Boynton Beach, FL 33435 USA Bethesda Mem Hosp 2815 S Seacrest Blvd Boynton Beach FL USA 33435
Citazione:
J.T. Parsons et al., "Treatment of early and moderately advanced vocal cord carcinoma with 6-MV X-rays", INT J RAD O, 50(4), 2001, pp. 953-959

Abstract

Purpose: Whereas there are many reports regarding treatment of early vocalcord cancer with cobalt 60 or 2-4-MV X-rays, there are still few reports on the results of treatment with 6-MV X-rays. Theoretically, 6-MV X-rays result in greater underdosage of tumor at the air-tissue interface and at the anterior commissure. This paper analyzes the results of irradiation of early and moderately advanced squamous cell carcinoma of the true vocal cord treated exclusively with 6-MV X-rays in a community hospital. The literature pertinent to the issue is reviewed. Methods and Materials: Eighty-three patients with Tis, T1, T2, or T3 squamous cell carcinoma of the true vocal cord were treated with curative intentat Bethesda Memorial Hospital in Boynton Beach, Florida between April 1986and April 1998. The dose schedules most commonly used were 63 Gy in 28 fractions (2.25 Gy per fraction once a day) for T1 tumors or 74.40 Gy in 62 fractions (1.2 Gy per fraction twice a day) for T2 and T3 tumors. All patients have minimum 2-year follow-up; 63 (76%) have 5-year minimum follow-up. Results: Local control was achieved in 6 of 6 Tis, 53 of 54 (98%) T1, 8 of8 T2, and 6 of 6 T3 lesions. No complications were encountered. Conclusions: A recent literature review indicates that the treatment of early vocal cord cancer with 6-MV X-rays remains controversial. The dose schedules used in the present paper produced a high rate of local control, a finding that is consistent with reports of other investigators who used dose schedules similar to those used in the present series. However, several other investigators have reported significantly lower rates of local control for T1 or T2 glottic cancer treated with 6-MV X-rays when compared to results obtained with cobalt 60 or 4 MV at their own institution. The latter institutions used lower total doses and/or Lower dose per fraction than those institutions reporting high rates of local control with 6 MV. Data from the literature, as well as our own data, are consistent with the following hypotheses: (1) the lower rates of local control reported by several institutions when using 6 MV compared with cobalt or 2-4 MV, using the same radiationdose schedules for each beam energy, indicate that underdosage of mucosal surfaces in the laryngeal air cavity may be a clinically important phenomenon, and (2) time-dose factors, although certainly important for lower energy beams, may be even more important when using 6 MV. (C) 2001 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/09/20 alle ore 13:43:57