Yao Ji-Jin, Zhou Guan-Qun, Lin Li, Zhang Wang-Jian, Peng Ying-Lin, Chen Lei, Tang Ling-Long, Mao Yan-Ping, Ma Jun, Sun Ying
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, People's Republic of China.
Department of Medical Statistics and Epidemiology &Health Information Research Center &Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
Sci Rep. 2015 Sep 1;5:13525. doi: 10.1038/srep13525.
This study is to identify significant dosimetric parameters for ear disorders in nasopharyngeal carcinoma (NPC) patients treated with intensity modulated therapy only. Ninety-seven patients with NPC were retrospectively reviewed. Organs at risk (OARs) in the auditory apparatus were contoured. Dose-volume histogram parameters were generated for the Eustachian tube (ET), tympanic cavity (TC), mastoid air cells, vestibular apparatus, cochlea and internal auditory canal (IAC). Ear disorders were rated 0 (none), 1 (mild) or 2 (severe) by a clinician blinded to radiation doses; Grade 2 ear disorders was the study end-point. Multivariate analysis revealed ET.D30 (dose to 30% of ET volume) >52.75 Gy and M.D0.5CC (dose to 0.5 ml of mastoid volume) >41.04 Gy (OR = 3.77, P = 0.012 and OR = 1.27, P = 0.033, respectively) were associated with Grade 2 ear disorders. Our results demonstrated that post-irradiation ear disorders remain a common late toxicity in NPC after IMRT. ET.D30 and M.D0.5CC should be considered during IMRT treatment plan optimization, review and approval.
本研究旨在确定仅接受调强放疗的鼻咽癌（NPC）患者耳部疾病的重要剂量学参数。回顾性分析了97例NPC患者。勾勒出听觉器官中的危及器官（OARs）轮廓。生成了咽鼓管（ET）、鼓室（TC）、乳突气房、前庭器官、耳蜗和内耳道（IAC）的剂量体积直方图参数。由对辐射剂量不知情的临床医生将耳部疾病评为0级（无）、1级（轻度）或2级（重度）；2级耳部疾病是研究终点。多变量分析显示，ET.D30（ET体积的30%所接受的剂量）>52.75 Gy和M.D0.5CC（乳突体积0.5 ml所接受的剂量）>41.04 Gy（OR分别为3.77，P = 0.012和OR = 1.27，P = 0.033）与2级耳部疾病相关。我们的结果表明，放疗后耳部疾病仍然是IMRT治疗后NPC常见的晚期毒性反应。在IMRT治疗计划的优化、审查和批准过程中应考虑ET.D30和M.D0.5CC。
