Co Jayson, Mejia Michael Benedict, Dizon Janine Margarita
Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines.
Head Neck. 2016 Apr;38 Suppl 1:E2130-42. doi: 10.1002/hed.23977. Epub 2015 Jun 17.
Current management of nasopharyngeal carcinoma (NPC) uses radiotherapy (RT) as the curative treatment modality. Radiation delivery techniques for NPC can be achieved using 2D conventional RT or intensity-modulated radiotherapy (IMRT).
A systematic review and meta-analysis of the literature was undertaken to assess the effectiveness of IMRT versus 2D conventional RT in primary treatment of NPC.
IMRT showed better results than 2D conventional RT in terms of local control, regional control, and overall survival, but when stratified, only in T4, N2, and stage III were the differences that were seen. Objective saliva measurements and physician-graded xerostomia were better in IMRT. However, patient-reported xerostomia showed minimal improvement only in IMRT. The evidence of superiority of IMRT over 2D conventional RT is not clear.
In the absence of more clinical data demonstrating the superiority of IMRT in the treatment of nasopharyngeal carcinoma, 2D conventional RT seems to be a reasonable treatment option, especially in limited resource settings. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2130-E2142, 2016.
目前鼻咽癌（NPC）的治疗以放射治疗（RT）作为根治性治疗方式。鼻咽癌的放射治疗技术可采用二维传统放疗或调强放疗（IMRT）。
对文献进行系统评价和荟萃分析，以评估调强放疗与二维传统放疗在鼻咽癌初始治疗中的有效性。
在局部控制、区域控制和总生存率方面，调强放疗的效果优于二维传统放疗，但分层分析时，仅在T4、N2和III期观察到差异。调强放疗中客观唾液测量和医生分级的口干情况较好。然而，患者报告的口干情况仅在调强放疗中有轻微改善。调强放疗优于二维传统放疗的证据尚不明确。
在缺乏更多临床数据证明调强放疗在鼻咽癌治疗中的优越性的情况下，二维传统放疗似乎是一种合理的治疗选择，尤其是在资源有限的环境中。©2015威利期刊公司。头颈外科38：E2130-E2142，2016年。
