Baş-boyun kanseri tanısı ile radyopterapi gören olgularda geç yan etkilerinin değerlendirilmesi
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Baş-boyun bölgesine yönelik radyoterapi gören 120 olgu, geç yan etkiler ve görülme sıklığını etkileyen prognostik faktörlerin belirlenmesi amacıyla kliniğimizde tedavi sonrası en erken 6. ayda olmak üzere "Radiation Therapy Oncology Group/ European Organization for Research and Treatment of Cancer" (RTOG/EORTC) kriterlerine göre değerlendirilmiştir. Gereç ve Yöntem: Tümör yerleşimi; 53 olguda (%44.2) larinks, 17 (%14.2) olguda nazofarinks, 13 (%10.8) olguda dil, 7 (%5.8) olguda ağız tabanı, bukkal mukoza, 10 olguda (%8.3) hipofarinks, tonsil veya parotiste olup, 20 (%16.7) olguya primeri bilinmeyen servikal lenf bezi metastazı nedeniyle baş-boyun bölgesinden radyoterapi uygulanmıştır. Radyoterapi dozu medyan 66 Gy (aralık:54-90 Gy) olup, tedavi 103 olguda Co 60 teleterapi cihazı ile 17 olguda ise 6-25 MV lineer hızlandırıcı ile uygulanmıştır. Bulgular:Geç yan etki açısından sorguladığımız 120 olgunun 17'sinde (%14.2) geç yan etki gözlenmezken, 39 olguda (%32.5) derece 1, 49 olguda (%40.8) derece 2, 15 olguda (%12.5) derece 3 toksisite ile karşılaşılmıştır. Geç yan etki gelişimini etkileyebilecek faktörler araştırıldığında, cins (p=0.799), operasyon uygulanması (p=0.743), radyoterapi dozu(<66 Gy) (p=0.229), kullanılan foton enerjisi (Co 60 veya 6 MV) (p=0.860), sosyoekonomik durum (p=0.440), kemoterapi uygulaması (p=0.656) ile geç yan etki gelişimi arasında istatistiksel anlamlı ilişki bulunmazken, uygulanan operasyon tipinin (yalnız tümör eksizyonu ve tümör eksizyonuyla birlikte boyun disseksiyonu) geç yan etki oranlarını arttırdığı belirlenmiştir (p=0.004). Ayrıca ağız mukozasının %50'sinden fazlasının saha içinde kalması durumunda geç yan etki oranlarının yükseldiği saptanmıştır (p=0.006). Sonuç: Baş-boyun kanseri nedeniyle radyoterapi uygulanan olgularda farklı derecelerde olmakla birlikte yüksek oranda geç toksisiteye rastlanmaktadır. Bu yan etkilerin daha ayrıntılı bir şekilde standart bir derecelendirme sistemi kullanarak her hastada radyoterapiden önce, radyoterapi sırasında ve sonrasında değerlendirilmesi belki de geç toksisite görülebilecek olguları önceden belirleyip buna yönelik koruyucu tedbirler almamızda yardımcı olacak ve hastaların yaşam kalitesini yükseltecektir.
Purpose: in order to evaluate the late radiation toxicity and the prognostic factors influencing the development of late toxicity 120 patients who received radiotherapy to head and neck region were evaluated according to RTOG/EORTC (Radiation Therapy Oncology Group/ European Organization for Research and Treatment of Cancer) scoring criteria.Patients and Methods: Tumor localization was as follows: larynx 53 patients (44.2%), nasopharynx 17 patients (14.2%), tongue 13 patients (10.8%), floor of the mouth, buccal mucosa 7 patients (5.8%), hypopharynx, tonsil and parotis 10 patients (8.3%), unknown primary with cervical lymph node metastases 20 patients (16.7%). Median irradiation dose was 66 Gy (range:54-90). in 103 patients Co 60 teleterapy machine and in 17 patients 6-25 MV lineer accelarator was used.Results: No late radiation toxicity was seen in 17 patients (14.2%). Thirty-nine patients (32.5%) had Grade I, 49 had (40.8%) Grade II and 15 had (12.5%) Grade III toxicity. Prognostic factors such as gender (p=0.799), prior operation (0.743), irradiation dose (<66 Gy)(p=0.229), beam energy (p=0.860), socioeconomic status (p=0.440), use of chemotherapy (p=0.656) had no significant effect on the development of toxicity, but the operation type (tumor excision alone or tumor excision with neck dissection) had significant impact (p=0.004). Also late toxicity was more frequent when more than 50% of oral mucosa was included in the treatment field (p=0.006).Conclusion: High rates of late radiation toxicity of various grades develop in patients with head and neck cancer. Side effects should be evaluated in each patient before, during or after radiotherapy using a standard grading system. Thus the patients susceptible to develop late effects could be predicted and with the necessary precautions quality of life could be improved.
Purpose: in order to evaluate the late radiation toxicity and the prognostic factors influencing the development of late toxicity 120 patients who received radiotherapy to head and neck region were evaluated according to RTOG/EORTC (Radiation Therapy Oncology Group/ European Organization for Research and Treatment of Cancer) scoring criteria.Patients and Methods: Tumor localization was as follows: larynx 53 patients (44.2%), nasopharynx 17 patients (14.2%), tongue 13 patients (10.8%), floor of the mouth, buccal mucosa 7 patients (5.8%), hypopharynx, tonsil and parotis 10 patients (8.3%), unknown primary with cervical lymph node metastases 20 patients (16.7%). Median irradiation dose was 66 Gy (range:54-90). in 103 patients Co 60 teleterapy machine and in 17 patients 6-25 MV lineer accelarator was used.Results: No late radiation toxicity was seen in 17 patients (14.2%). Thirty-nine patients (32.5%) had Grade I, 49 had (40.8%) Grade II and 15 had (12.5%) Grade III toxicity. Prognostic factors such as gender (p=0.799), prior operation (0.743), irradiation dose (<66 Gy)(p=0.229), beam energy (p=0.860), socioeconomic status (p=0.440), use of chemotherapy (p=0.656) had no significant effect on the development of toxicity, but the operation type (tumor excision alone or tumor excision with neck dissection) had significant impact (p=0.004). Also late toxicity was more frequent when more than 50% of oral mucosa was included in the treatment field (p=0.006).Conclusion: High rates of late radiation toxicity of various grades develop in patients with head and neck cancer. Side effects should be evaluated in each patient before, during or after radiotherapy using a standard grading system. Thus the patients susceptible to develop late effects could be predicted and with the necessary precautions quality of life could be improved.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Türkiye Klinikleri Tıp Bilimleri Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
3
