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调强放疗与非调强放疗治疗鼻咽癌幸存者的长期晚期毒性反应及生活质量

Long-term late toxicities and quality of life for survivors of nasopharyngeal carcinoma treated with intensity-modulated radiotherapy versus non-intensity-modulated radiotherapy.

作者信息

Huang Tai-Lin, Chien Chih-Yen, Tsai Wen-Ling, Liao Kuan-Cho, Chou Shang-Yu, Lin Hsin-Ching, Dean Luo Sheng, Lee Tsair-Fwu, Lee Chien-Hung, Fang Fu-Min

机构信息

Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Head Neck. 2016 Apr;38 Suppl 1:E1026-32. doi: 10.1002/hed.24150. Epub 2015 Jul 18.

Abstract

BACKGROUND

The purpose of this study was to investigate late toxicities and quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) with long-term survival after treatment by intensity-modulated radiotherapy (IMRT) versus non-IMRT.

METHODS

An observational, cross-sectional study of QOL and late toxicities was conducted in 242 patients with NPC with survival of >5 years after treatment with IMRT (n = 100) or non-IMRT (n = 142) by using physician-assessed toxicities (Common Terminology Criteria for Adverse Events [CTCAE] version 4) and the patient-reported European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC QLQ-C30) and the Head and Neck 35-questions (EORTC QLQ-C30-H&N35) module.

RESULTS

The IMRT group had both statistically (p < .05) and clinically (difference of predicted mean scores ≥10 points) better outcome in global QOL, cognitive functioning, social functioning, fatigue, and 11 scales of the head and neck module. Late toxicities, including neuropathy, hearing loss, dysphagia, xerostomia, and neck fibrosis were significantly less severe in the IMRT group. Multivariate analysis revealed that the radiotherapy (RT) technique was statistically significantly associated with late toxicities and QOL outcome after adjusting for other clinical and demographic variables.

CONCLUSION

The use of the IMRT technique was associated with the improvement of physician-assessed late toxicities and patient-reported QOL in NPC survivors. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1026-E1032, 2016.

摘要

背景

本研究旨在调查接受调强放疗(IMRT)与非调强放疗的鼻咽癌(NPC)长期生存患者的晚期毒性反应及生活质量(QOL)。

方法

采用医生评估的毒性反应(不良事件通用术语标准[CTCAE]第4版)以及患者报告的欧洲癌症研究与治疗组织生活质量问卷核心30题(EORTC QLQ-C30)和头颈35题(EORTC QLQ-C30-H&N35)模块,对242例接受IMRT(n = 100)或非IMRT(n = 142)治疗后存活超过5年的NPC患者进行了一项关于生活质量和晚期毒性反应的观察性横断面研究。

结果

在总体生活质量、认知功能、社会功能、疲劳以及头颈模块的11个量表方面,IMRT组在统计学上(p < 0.05)和临床上(预测平均得分差异≥10分)均有更好的结果。IMRT组的晚期毒性反应,包括神经病变、听力丧失、吞咽困难、口干和颈部纤维化明显较轻。多因素分析显示,在调整了其他临床和人口统计学变量后,放疗(RT)技术与晚期毒性反应和生活质量结果在统计学上显著相关。

结论

IMRT技术的使用与鼻咽癌幸存者中医生评估的晚期毒性反应改善以及患者报告的生活质量提高相关。© 2015威利期刊公司。头颈38: E1026-E1032, 2016。

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