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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2021-20-2-29-36</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-1752</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>ХИМИОЛУЧЕВАЯ ТЕРАПИЯ БОЛЬНЫХ РАКОМ СЛИЗИСТОЙ ОБОЛОЧКИ ПОЛОСТИ РТА С ИСПОЛЬЗОВАНИЕМ ГИПЕРФРАКЦИОНИРОВАНИЯ ДОЗЫ ОБЛУЧЕНИЯ</article-title><trans-title-group xml:lang="en"><trans-title>CHEMORADIOTHERAPY FOR ORAL CANCER USING HYPERFRACTIONATED RADIATION SCHEDULE</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Раджапова</surname><given-names>М. У.</given-names></name><name name-style="western" xml:lang="en"><surname>Radzhapova</surname><given-names>M. U.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, ведущий научный сотрудник отделения протонной и фотонной терапии</p><p>SPIN-код: 4127-7361. AuthorID (РИНЦ): 696495</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p> MD, PhD, Leading Researcher, Department of Proton and Photon Therapy </p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><email xlink:type="simple">mradzh@mrrc.obninsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гулидов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gulidov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий отделом лучевой терапии</p><p>SPIN-код: 2492-5581. AuthorID (РИНЦ): 597359</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p> MD, DSc, Professor, Head of the Department of Radiation Therapy </p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9756-6275</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Севрюков</surname><given-names>Ф. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Sevryukov</surname><given-names>F. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, заведующий отделом лучевого и хирургического лечения заболеваний головы, шеи,</p><p>SPIN-код: 9689-0400. AuthorID (РИНЦ): 857000</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p> MD, PhD, Head of the Department of Radiation and Surgical Therapy of Head and Neck Diseases </p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мардынский</surname><given-names>Ю. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Mardynsky</surname><given-names>Yu. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, член-корреспондент РАН, профессор, главный научный сотрудник отделения протонной и фотонной терапии</p><p>SPIN-код: 3393-8914. AuthorID (РИНЦ): 161732</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p>MD, DSc, Professor, Corresponding Member of the Russian Academy of Sciences, Leading Researcher, Department of Proton and Photon Therapy</p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4537-0534</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панасейкин</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Panaseykin</surname><given-names>J. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>научный сотрудник отделения радиохирургического лечения закрытыми радионуклидами</p><p>SPIN-код: 7581-0055. AuthorID (РИНЦ): 898681</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p>MD, Researcher, Department of Radiosurgical Therapy with Encapsulated Radionuclides</p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семенов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник отделения протонной и фотонной терапии</p><p>SPIN-код: 3901-1289. AuthorID (РИНЦ): 926728</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p> Junior Researcher, Department of Proton and Photon Therapy</p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7689-6032</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванов</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор РАН, директор</p><p>SPIN-код: 4264-5167. AuthorID (РИНЦ): 710405</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p>MD, DSc, Professor, Director</p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8784-8415</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Каприн</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Kaprin</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, академик РАН, генеральный директор</p><p>SPIN-код: 1759-8101. AuthorID (РИНЦ): 96775</p><p> Россия, 249036, г. Обнинск, ул. Королева, 4 </p></bio><bio xml:lang="en"><p>MD, DSc, Professor, Academician of the Russian Academy of Sciences, General Director of National Medical Research Center of Radiology</p><p> Russia, 249036, Obninsk, Koroliova Street, 4 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Медицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A.F. Tsyb Medical Radiological Research Center – Branch of the Federal State Budget Institution «National Medical Research Center of Radiology» of the Health Ministry of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>28</day><month>04</month><year>2021</year></pub-date><volume>20</volume><issue>2</issue><fpage>29</fpage><lpage>36</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Раджапова М.У., Гулидов И.А., Севрюков Ф.Е., Мардынский Ю.С., Панасейкин Ю.А., Семенов А.В., Иванов С.А., Каприн А.Д., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Раджапова М.У., Гулидов И.А., Севрюков Ф.Е., Мардынский Ю.С., Панасейкин Ю.А., Семенов А.В., Иванов С.А., Каприн А.Д.</copyright-holder><copyright-holder xml:lang="en">Radzhapova M.U., Gulidov I.A., Sevryukov F.E., Mardynsky Y.S., Panaseykin J.A., Semenov A.V., Ivanov S.A., Kaprin A.D.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/1752">https://www.siboncoj.ru/jour/article/view/1752</self-uri><abstract><p> Цель исследования – оценка эффективности и токсичности одновременной химиолучевой терапии больных раком слизистой оболочки полости рта с использованием  ускоренного гиперфракционирования дозы облучения. </p><sec><title>Материал и методы</title><p>Материал и методы. Клинические наблюдения представлены 79 пациентами, проходившими лучевую терапию на облучательных установках «Терабалт» в режиме ускоренного гиперфракционирования с одновременным проведением 2 циклов полихимиотерапии по схеме pF. Дневная доза 2,5 Гр была разделена на две фракции: 1,0 Гр и 1,5 Гр, которые подводились с 5–6-часовым интервалом  ежедневно 5 раз в нед до суммарной очаговой дозы 60,0 Гр  и 50,0 Гр на зоны высокого и низкого риска соответственно. </p></sec><sec><title>Результаты</title><p>Результаты. Полная регрессия, частичная регрессия, стабилизация выявлены в 63,3 %, 35,4 %, 1,3 % случаев соответственно. Пятилетняя общая и безрецидивная выживаемость в целом в группе составила 54,5 % и 50,4 %  соответственно. В подгруппе больных со стадиями опухоли T3–4 пятилетняя общая выживаемость составила 50,8 %, безрецидивная – 47,2 %. Тяжелые мукозиты (III степени) выявлены у 36,7 % больных. В зоне облучения на кожных покровах у 85 % пациентов отмечались лучевые реакции, которые были оценены как кожная токсичность первой степени. Остеорадионекрозы нижней челюсти развились в 8,9 % случаев. Все пациенты, включенные в исследование, завершили запланированный курс химиолучевого лечения. </p></sec><sec><title>Заключение</title><p>Заключение. Одновременная химиолучевая терапия с ускоренным гиперфракционированием дозы облучения 1,0 Гр + 1,5 Гр может рассматриваться как эффективный  вариант противоопухолевой терапии при выборе  оптимальной тактики лечения больных раком органов  полости рта при наличии противопоказаний к хирургическому вмешательству.  </p></sec></abstract><trans-abstract xml:lang="en"><sec><title> Purpose</title><p> Purpose: to assess the efficacy and toxicity of concurrent  chemoradiotherapy with accelerated hyperfractionation in the treatment of  oral cancer. </p></sec><sec><title>Material and Methods</title><p>Material and Methods. A total of 79 patients with oral cancer were enrolled in this study. Accelerated hyperfractionated radiation therapy was administered using terabalt unit concurrently with two cycles of pF chemotherapy. The daily dose of 2.5 Gy was divided into two fractions of 1.0 Gy and 1.5 Gy which were delivered to high- and low-risk areas with 5–6-hour-interval between each treatment, 5 days per week to a total dose of 60.0 Gy and 50.0 Gy, respectively. </p></sec><sec><title>Results</title><p>Results. Complete response, partial response and stable disease were achieved in 63.3 %, 35.4 % and 1.3 % of and relapse-free survival rates for the entire group of patients were 54.5 % and 50.4 %, respectively. In the subgroup of patients with T3–4 stage tumors, the five-year overall survival rate was 50.8 %, and the five-year relapse-free survival rate was 47.2 %. Severe oral mucositis (grade 3) was noted in 36.7 % of patients. Grade 1 dermal toxicity was observed in 85 % of patients who experienced radiation-induced skin reactions. In 8.9 % of patients, osteoradionecrosis of the mandible occurred. All the patients included in the study completed the course of chemoradiotherapy as planned. </p></sec><sec><title>Conclusion</title><p>Conclusion. Concurrent chemoradiotherapy with accelerated hyperfractionation (1.0 Gy + 1.5 Gy) appears to be an effective treatment option for oral cavity cancer patients in whom surgery is contraindicated. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>химиолучевая терапия</kwd><kwd>рак полости рта</kwd><kwd>гиперфракционирование</kwd><kwd>выживаемость</kwd><kwd>токсичность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chemoradiotherapy</kwd><kwd>oral cavity cancer</kwd><kwd>hyperfractionation</kwd><kwd>survival</kwd><kwd>toxicity</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018 Jan; 68(1): 7–30. doi: 10.3322/caac.21442.</mixed-citation><mixed-citation xml:lang="en">Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2018. 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