鼻咽癌中减少照射体积的调强放射治疗对疾病控制的影响。
The impact of reduced-volume, intensity-modulated radiation therapy on disease control in nasopharyngeal carcinoma.
作者信息
Lin Yu-Wei, Chen Chia-Chun, Lin Li-Ching, Lee Steve P
机构信息
Department of Radiation Oncology, Chi Mei Medical Center, Tainan, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; The School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Radiation Oncology, Liouying campus, Chi Mei Medical Center, Tainan, Taiwan.
出版信息
PLoS One. 2015 Apr 28;10(4):e0125283. doi: 10.1371/journal.pone.0125283. eCollection 2015.
OBJECTIVE
To investigate the feasibility of using intensity-modulated radiotherapy (IMRT) with reduced, high-dose target volumes for nasopharyngeal carcinoma (NPC).
METHODS
The first 57 patients (admitted from October 2005 to May 2008) were treated with large-target-volume IMRT (LV-IMRT). For the LV-IMRT group, the CTV at 70 Gy (CTV70) was delineated as the gross target volume (GTV) plus 7mm, with or without the first-echelon lymph-node region. The next 56 patients (admitted from June 2008 to November 2011) were treated with reduced-target-volume IMRT (RV-IMRT). For the RV-IMRT group, the CTV70 was delineated as the GTV alone.
RESULTS
The 4-year local recurrence-free, regional recurrence-free, distant metastasis-free, progression-free, and overall survival rates were 77.2%, 80.1%, 83.2%, 61.2%, and 74.4% for the LV-IMRT group and 83.5%, 92.6%, 89.1%, 78.5, and 91.0% for the RV-IMRT group, respectively. Late toxicity scoring of xerostomia was lesser in the RV-IMRT group than the LV-IMRT group (P < 0.001).
CONCLUSIONS
The use of RV-IMRT for the treatment of NPC did not negatively affect survival rates but did reduce the late xerostomia events compared to LV-IMRT.
目的
探讨采用缩小的高剂量靶区容积调强放疗（IMRT）治疗鼻咽癌（NPC）的可行性。
方法
前57例患者（2005年10月至2008年5月入院）接受大靶区容积IMRT（LV-IMRT）治疗。对于LV-IMRT组，70 Gy时的临床靶区（CTV70）勾画为大体肿瘤靶区（GTV）加7mm，包括或不包括第一梯队淋巴结区域。接下来的56例患者（2008年6月至2011年11月入院）接受缩小靶区容积IMRT（RV-IMRT）治疗。对于RV-IMRT组，CTV70仅勾画为GTV。
结果
LV-IMRT组的4年局部无复发生存率、区域无复发生存率、远处无转移生存率、无进展生存率和总生存率分别为77.2%、80.1%、83.2%、61.2%和74.4%，RV-IMRT组分别为83.5%、92.6%、89.1%、78.5%和91.0%。RV-IMRT组口干的晚期毒性评分低于LV-IMRT组（P<0.001）。
结论
与LV-IMRT相比，采用RV-IMRT治疗NPC对生存率没有负面影响，但确实减少了晚期口干事件。
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