Graduate School of Medicine Department of Radiology, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
J Radiat Res. 2012 Sep;53(5):704-9. doi: 10.1093/jrr/rrs021. Epub 2012 Jul 10.
We analyzed the correlation between primary tumor response within 6 months after radiation therapy (RT) including proton beam therapy (PBT) and progression free survival rate (PFS) in patients with nasal cavity and paranasal sinus malignancies to clarify the impact of early radiological evaluation of treatment response on prognosis. Sixty-five patients treated between January 1998 and December 2008, and whose follow-up duration was more than 2 years were included. The Response Evaluation Criteria in Solid Tumors (version 1.1) was used for the evaluation of treatment. Median age was 59 years (range 21-83 years). Olfactory neuroblastoma (n = 20, 30%) and squamous cell carcinoma (n = 15, 23%) were the major pathological tumor types. The median follow-up duration was 51.6 months. Radiological response evaluation within 6 months after treatment demonstrated that 15% of the patients achieved complete response (CR), and 3-year progression free survival rates of all patients was 49.2%. The 3-year PFS rates according to response for the treatment were 55.6% in the patients with CR and 46.4% in those with non-CR, respectively (P = 0.643). However, the 3-year PFS rates were 80.% in the patients with CR and 10.% in those with non-CR (P = 0.051) in the patients with squamous cell carcinoma (SCC) histology. Radiological response evaluation within 6 months did not have a significant impact on prognosis when analysis included all histology, although early radiological response within 6 months after RT had a borderline significant impact on treatment outcomes for the patients with nasal and paranasal SCC.
我们分析了 65 例鼻腔和鼻窦恶性肿瘤患者放疗（RT）包括质子束治疗（PBT）后 6 个月内原发肿瘤反应与无进展生存率（PFS）之间的相关性，以阐明早期放射反应评估对预后的影响。这些患者的治疗时间在 1998 年 1 月至 2008 年 12 月之间，随访时间均超过 2 年。采用实体瘤反应评估标准（第 1.1 版）评估治疗效果。中位年龄为 59 岁（21-83 岁）。嗅神经母细胞瘤（20 例，30%）和鳞状细胞癌（15 例，23%）是主要的病理肿瘤类型。中位随访时间为 51.6 个月。治疗后 6 个月的影像学反应评估显示，15%的患者达到完全缓解（CR），所有患者的 3 年无进展生存率为 49.2%。根据治疗反应的 3 年 PFS 率，CR 患者为 55.6%，非 CR 患者为 46.4%（P=0.643）。然而，在鳞状细胞癌（SCC）患者中，CR 患者的 3 年 PFS 率为 80.%，而非 CR 患者为 10.%（P=0.051）。尽管 RT 后 6 个月内的早期影像学反应对鼻腔和鼻窦 SCC 患者的治疗结果有一定的影响，但当分析包括所有组织学类型时，6 个月内的影像学反应评估对预后没有显著影响。
