臨床外科67巻8号

2012年08月発行

特集 知っておきたい放射線・粒子線治療

頭頸部癌に対する放射線治療の現況と展望

著者： 古平毅¹

所属機関： ¹愛知県がんセンター中央病院放射線治療科

ページ範囲：P.970 - P.976

【ポイント】

◆亜部位，病期を考慮のうえ（化学）放射線治療により臓器・機能温存が可能でQOLの高い治療が行える．

◆咽頭癌の放射線治療では，強度変調放射線治療により唾液腺機能温存が可能であるので適応を考慮する．

◆画像診断の進歩，バイオマーカーの応用により治療の個別化が可能になり，適切な治療選択の参考情報になる．

参考文献

1）Nutting CM, Morden JP, Harrington KJ, et al；PARSPORT trial management group：Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer（PARSPORT）：a phase 3 multicentre randomised controlled trial. Lancet Oncol 12：127-136, 2011

2）Machtay M, Moughan J, Trotti A, et al：Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer：an RTOG analysis. J Clin Oncol 26：3582-3589, 2008

3）Kodaira T, Tomita N, Tachibana H, et al：Aichi cancer center initial experience of intensity modulated radiation therapy for nasopharyngeal cancer using helical tomotherapy. Int J Radiat Oncol Biol Phys 73：1129-1134, 2009

4）Zenda S, Kawashima M, Nishio T, et al：Proton beam therapy as a nonsurgical approach to mucosal melanoma of the head and neck：a pilot study. Int J Radiat Oncol Biol Phys 81：135-139, 2011

5）Bernier J, Domenge C, Ozsahin M, et al：Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350：1945-1952, 2004

6）Cooper JS, Pajak TF, Forastiere AA, et al：Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350：1937-1944, 2004

7）Vermorken JB, Mesia R, Rivera F, et al：Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359：1116-1127, 2008

8）Chen Y, Liu MZ, Liang SB, et al：Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china. Int J Radiat Oncol Biol Phys 71：1356-1364, 2008

9）Chua DT, Ma J, Sham JS, et al：Improvement of survival after addition of induction chemotherapy to radiotherapy in patients with early-stage nasopharyngeal carcinoma：Subgroup analysis of two Phase Ⅲ trials. Int J Radiat Oncol Biol Phys 65：1300-1306, 2006

10）Bonner JA, Harari PM, Giralt J, et al：Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer：5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11：21-28, 2010

11）Chung MK, Jeong HS, Park SG, et al：Metabolic tumor volume of[18F]-fluorodeoxyglucose positron emission tomography/computed tomography predicts short-term outcome to radiotherapy with or without chemotherapy in pharyngeal cancer. Clin Cancer Res 15：5861-5868, 2009

12）Levendag PC, Teguh DN, Voet P, et al：Dysphagia disorders in patients with cancer of the oropharynx are significantly affected by the radiation therapy dose to the superior and middle constrictor muscle：a dose-effect relationship. Radiother Oncol 85：64-73, 2007

13）Simone CB, 2nd, Ly D, Dan TD, et al：Comparison of intensity-modulated radiotherapy, adaptive radiotherapy, proton radiotherapy, and adaptive proton radiotherapy for treatment of locally advanced head and neck cancer. Radiother Oncol 101：376-382, 2011