头颈肿瘤治疗课件.pptVIP

头颈部肿瘤治疗;头颈肿瘤的治疗手段;手术治疗;手术治疗缺点;头颈部肿瘤功能保全性治疗;目 的;治疗对象;治疗模式;Radiotherapy ;适 应 症;治疗方法;常规分割的单纯放疗;舌根癌治疗;超分割放疗的随机分组研究;RTOG 90-03, fractionation schedules;RTOG 90-03, loco-regional control;RTOG 90-03, survival;Preoperative RT;RTOG 73-03; Pre versus post-operative radiotherapy of resectable squamous cell carcinoma of the head and neck. 11 reports published during 1965-91， evaluating pre- vs. post- operative RT given at comparable dose levels. 2 reports were of prospective, randomised and nine of retrospective comparisons. Wennerberg Acta Otolaryngol 1995，115(4):465-74 ; The eleven studies comprised 1,358 patients (326 in prospective studies). The bulk of the evidence clearly suggests post-operative loco-regional control to be superior to pre-operative RT. However, this seems to be offset by the subsequent development of distant metastases or metachronous tumours. Wennerberg Acta Otolaryngol 1995，115(4):465-74;Chemotherapy;理想的放疗增敏剂;化疗增敏的理论基础;放疗合并化疗常用的药物;化疗与放射治疗的结合方式;诱导化疗+放疗;治疗模式;诱导化疗+放射治疗的II期研究;诱导化疗的III期随机分组研究;结 论 (1);诱导化疗加放疗无严重的副作用。 临床或病理CR，无病生存率显著高于未达到CR者。;诱导化疗组的缺点;术后化疗+放疗或同步化放疗;术后序贯化疗研究;RTOG 81-16;RTOG83-22 and IG0034;结 果;结 论;术后同步放化疗法国III期随机分组试验;结 果;结 论;Concurrent chemoradiotherapy;头颈部肿瘤同步放化疗随机研究结果;;Materials and methods;Results;Results;;Prognostic factors;Conclusion;Pignon JP Lancet 2000;63临床随机研究 10741例病人 67%的病人死亡 所有III期NPC在MDACC接受 同步化放疗; Treatment 5yr sur;5-FU和DDP增加4% 的5年总生存率;诱导化疗和辅助化疗对生存率无影响。 诱导化疗在器官保存为目的的治疗中，对生存率无显著的作用。 同步放化疗可显著提高局部控制率和生存率。;Concurrent Chemotherapy and Radiotherapy for Organ Preservation in Advanced Laryngeal Cancer RTOG 91-11 ;Purpose;RTOG 91-11;RTOG 91-11入组条件;Laryngeal preservation ;Local-regional control;Distance