Sung Soo Yoon, Kang Min Kyu, Kay Chul Seung, Keum Ki Chang, Kim Sung Hwan, Kim Yeon-Sil, Kim Won Taek, Kim Ji-Yoon, Kim Jin-Hee, Moon Sung Ho, Ahn Yong Chan, Oh Young Taek, Wu Hong-Gyun, Lee Chang-Geol, Chung Woong-Ki, Cho Kwan Ho, Cho Moon-June, Choi Jin Hwa
Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Radiat Oncol J. 2015 Sep;33(3):188-97. doi: 10.3857/roj.2015.33.3.188. Epub 2015 Sep 30.
To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea.
A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions.
Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose.
Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.
调查韩国鼻咽癌（NPC）患者的治疗模式。
开展了一项多机构回顾性研究（韩国放射肿瘤学组[KROG]11 - 06），纳入了来自15个机构的1445例患者。
在1445例患者中，超过半数为Ⅲ期（39.9%）和Ⅳ期（35.8%）。除了治疗模式，我们还研究了1988 - 1993年、1994 - 2002年以及2003 - 2011年各时间段的变化趋势。与前两个时间段相比，第三个时间段磁共振成像和正电子发射断层扫描 - 计算机断层扫描的使用频率显著增加。894例患者（61.9%）接受了同步放化疗（CCRT），468例患者（32.4%）接受了新辅助化疗，366例患者（25.3%）接受了辅助化疗。在Ⅱ - Ⅳ期患者中，2003 - 2011年接受CCRT的比例为78.8%，而1988 - 1993年为15.0%。对于接受CCRT治疗的患者，81.3%的患者最常用的药物是顺铂。随着时间推移，常用的放射治疗（RT）技术从二维RT（1988 - 1993年，92.5%）转变为三维RT（2003 - 2011年，35.5%）或调强放疗（IMRT；2003 - 2011年，56.5%）。给予原发肿瘤、高危淋巴管和低危淋巴管的中位RT剂量分别为70.0 Gy、58.1 Gy和48.0 Gy。IMRT的采用增加了每次分割剂量并提高了总辐射剂量。
对韩国NPC患者治疗模式的评估表明，NPC的管理，包括诊断成像、治疗方案、RT技术和剂量方案，均符合国际指南并不断进步。
