vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2023-20-3-205-215vestim-927Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEВлияние перерывов в процессе лучевой терапии на отдаленные результаты лечения опухолей головы и шеи I-III стадии в отсутствие хирургического и химиолучевого леченияInfluence of interruptions in radiation therapy on long-term results of treatment of stage I-III head and neck cancers in the absence of surgical and chemoradiotherapyhttps://orcid.org/0000-0002-2041-5575БатянА. Н.BatyanA. N.

Батян Анатолий Николаевич – доктор медицинских наук, профессор, заведующий кафедрой.

ул. Долгобродская, 23/1, 220070, Минск

Anatoly N. Batyan – D. Sc. (Med.), Professor, Head of the Department, International Sakharov Environmental Institute of Belarusian State University.

23/1, Dolgobrodskaya Str., 220070, Minsk

ant_b@tut.byВолонцевичВ. Н.ValantsevichV. N.

Волонцевич Виталий Николаевич – врач радиационный онколог.

ул. Медицинская, 6, 224027, Брест

Vitali N. Valantsevich – radiation oncologist, Brest Regional Oncological Dispensary.

6, Meditsinskaya Str., 224027, Brest

valantsevich185@gmail.comhttps://orcid.org/0000-0003-4383-2360ГончароваЕ. В.HancharovaK. V.

Гончарова Екатерина Викторовна – аспирант.

ул. Долгобродская, 23/1, 220070, Минск

Katsiaryna V. Hancharova – Postgraduate student, International Sakharov Environmental Institute of Belarusian State University.

23/1, Dolgobrodskaya Str., 220070, Minsk

katsiaryna.hancharova@gmail.comhttps://orcid.org/0000-0002-1324-3656ДемешкоП. Д.DziameshkaP. D.

Демешко Павел Дмитриевич – доктор медицинских наук, доцент, главный научный сотрудник.

аг. Лесной, 223040, Минский район

Pavel D. Dziameshka – D. Sc. (Med.), Associate Professor, Chief Researcher, N.N. Alexandrov National Cancer Centre of Belarus.

Lesnoy, 223040, Minsk region

pdemeshko@me.comhttps://orcid.org/0000-0001-7757-1969ЛемешевскийВ. О.LemiasheuskiV. O.

Лемешевский Виктор Олегович – кандидат сельскохозяйственных наук, доцент.

ул. Долгобродская, 23/1, 220070, Минск

Viktar O. Lemiasheuski – Ph. D. (Agricult.), Associate Professor, International Sakharov Environmental Institute of Belarusian State University.

23/1, Dolgobrodskaya Str., 220070, Minsk

lemeshonak@yahoo.comМеждународный государственный экологический институт имени А. Д. Сахарова Белорусского государственного университетаInternational Sakharov Environmental Institute of Belarusian State UniversityБрестский областной онкологический диспансерBrest Regional Oncological DispensaryРеспубликанский научно-практический центр онкологии и медицинской радиологии им. Н.Н. АлександроваN.N. Alexandrov National Cancer Centre of Belarus202301092023203205215Copyright © Батян А.Н., Волонцевич В.Н., Гончарова Е.В., Демешко П.Д., Лемешевский В.О., 20232023Батян А.Н., Волонцевич В.Н., Гончарова Е.В., Демешко П.Д., Лемешевский В.О.Batyan A.N., Valantsevich V.N., Hancharova K.V., Dziameshka P.D., Lemiasheuski V.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/927

Несмотря на то что опухоли головы и шеи очень чувствительны к лучевому лечению, у пациентов, завершивших курс лучевой терапии, отмечается высокая частота рецидивов и смертности от основного заболевания.

Целью исследования являлся анализ бессобытийной выживаемости пациентов (Event-free survival – EFS), окончивших курс лучевой терапии рака головы и шеи I-III стадии по радикальной программе, под влиянием ряда независимых факторов, таких как возраст, пол, суммарная очаговая доза, стадия заболевания, длительность перерыва в расщепленном курсе лучевой терапии.

Влияние длительности перерывов на выживаемость оценивалось путем анализа схем лечения пациентов, получавших лучевую терапию по поводу рака головы и шеи I-III стадии по радикальной программе с 2016 по 2018 г. в Брестском областном онкологическом диспансере. Статистическая обработка полученных данных включала в себя анализ методом регрессии Кокса. Для оценки исхода был проведен анализ данных методом Каплана–Майера.

При многофакторном анализе установлено, что наибольшую связь с бессобытийной выживаемостью имеет стадия заболевания (p < 0,01). Та же тенденция наблюдается и для продолжительности перерыва в лучевом лечении (p < 0,05). В группе пациентов с продолжительностью перерыва в лучевом лечении менее 3 недель накопленное выживание значительно выше, чем у пациентов, завершивших лечение с перерывом более 3 недель (80,00 % против 49,06 %). При длительности перерыва менее 3 недель клиническая стадия (T1-T3) не является фактором, влияющим на выживаемость пациентов.

Учет влияния перерывов в курсе лучевой терапии и понимание влияния контролируемых факторов имеет важное значение для выбора оптимальной стратегии лечения.

Despite the fact that head and neck tumors are very sensitive to radiation treatment, patients who have completed a course of radiation therapy have a high rate of recurrence and mortality from the underlying disease.

The aim of the study was to analyze the event-free survival of patients who completed a course of radiation therapy for stage I-III head and neck cancer according to a radical program under the influence of a number of independent factors such as age, gender, total focal dose, disease stage, duration of a break in a split course of radiation therapy.

The effect of the duration of interruption on survival was assessed by analyzing the treatment regimens for patients who received radiation treatment for stage I-III head and neck cancer according to a radical program from 2016 to 2018 at the Brest Regional Oncological Dispensary. Statistical processing of the obtained data included the analysis by the Cox regression method. Data were analyzed using the Kaplan-Meier method to evaluate the outcome.

In the multivariate analysis, it was found that the disease stage has the greatest relationship with event-free survival (p < 0.01). The same trend is observed for the duration of interruption in radiotherapy (p < 0.05). The cumulative survival was significantly higher in the group of patients with treatment interruption of less than 3 weeks compared to the group of patients who completed treatment more than 3 weeks apart (80.00 % vs 49.06 %). If the duration of the break is less than 3 weeks, the clinical stage (T1-T3) is not a factor influencing patient survival.

Accounting for the effect of interruptions in the course of radiotherapy and the understanding the influence of controllable factors is essential for optimal treatment strategies.

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The authors declare that there are no conflicts of interest present.