Kristensen Claus A, Kjaer-Kristoffersen Flemming, Sapru Wendy, Berthelsen Anne K, Loft Annika, Specht Lena
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark.
Acta Oncol. 2007;46(2):214-20. doi: 10.1080/02841860600635862.
The study was undertaken in order to compare dose plans for intensity-modulated radiotherapy (IMRT) with 3D conformal radiotherapy (3D-CRT) dose plans in patients with nasopharyngeal carcinoma (NPC). Clinical data from 20 consecutive patients treated with IMRT are presented. For 11 patients 3D-CRT plans were made and compared to the IMRT plans with respect to doses to the planning target volumes (PTVs) and to organs at risk (OARs). For comparison of the conformation of dose to defined target volumes the conformity index (CI) was used. Target volume coverage and critical organ protection were significantly improved with IMRT compared to 3D-CRT. One-year loco-regional control, distant metastasis-free survival, and overall survival were 79%, 72%, and 80%. Two patients have had recurrence in the clinical target volume (CTV) only and seven patients have relapsed in distant organs and/or in head-and-neck areas outside the target areas. The study confirms that IMRT is superior to 3D-CRT in the treatment of NPC. As locoregional control of NPC improves we are facing an increasing number of recurrences outside the irradiated area.
开展这项研究是为了比较鼻咽癌（NPC）患者调强放射治疗（IMRT）与三维适形放射治疗（3D-CRT）的剂量计划。呈现了连续20例接受IMRT治疗患者的临床数据。对11例患者制定了3D-CRT计划，并在计划靶区（PTV）和危及器官（OAR）的剂量方面与IMRT计划进行比较。为比较对确定靶区的剂量适形度，使用了适形指数（CI）。与3D-CRT相比，IMRT显著改善了靶区覆盖和关键器官保护。1年局部区域控制率、无远处转移生存率和总生存率分别为79%、72%和80%。2例患者仅在临床靶区（CTV）复发，7例患者在远处器官和/或靶区外的头颈部区域复发。该研究证实，IMRT在NPC治疗中优于3D-CRT。随着NPC局部区域控制的改善，我们面临着越来越多的照射区域外复发情况。
