调强放疗同期化疗治疗局部晚期鼻咽癌患者剂量体积参数及临床因素对急性放射性口腔黏膜炎的影响。
Impact of dose volume parameters and clinical factors on acute radiation oral mucositis for locally advanced nasopharyngeal carcinoma patients treated with concurrent intensity-modulated radiation therapy and chemoradiotherapy.
机构信息
Department of Radiation Oncology, Affiliated Quanzhou First Hospital of Fujian Medical University, China.
Department of Oncology, Xinyu People's Hospital, China.
出版信息
Oral Oncol. 2017 Sep;72:32-37. doi: 10.1016/j.oraloncology.2017.06.026. Epub 2017 Jul 11.
PURPOSE
To prospectively identify the predictive value of different dosimetric parameters and also assess the predictors of acute radiation oral mucositis (ROM).
METHODS
In accordance with the RTOG scoring criteria, ninety-two patients with locally advanced nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy were evaluated for acute ROM which was defined as severe when the score ≥3. Patients' medical records and dosimetric data exported from IMRT plan enable the authors to perform a statistical analysis for the parameters as potential predictors of severe ROM.
RESULTS
Body weight loss and V30Gy (p=0.017 and 0.003, respectively) are related factors to severe ROM. As the receiver operating characteristics (ROC) curve shows, the threshold value of V30 for severe ROM was 73.155% (sensitivity, 0.842; specificity, 0.671), and the area under V30Gy curves was 0.753 (p=0.001).
CONCLUSION
New parameters were found as predictors of severe ROM using dosimetric analysis.
目的
前瞻性地确定不同剂量学参数的预测价值，并评估急性放射性口腔黏膜炎（ROM）的预测因子。
方法
根据 RTOG 评分标准，对 92 例接受同期放化疗的局部晚期鼻咽癌（NPC）患者进行急性 ROM 评估，当评分≥3 时定义为重度 ROM。作者从调强放疗计划中提取患者的病历和剂量学数据，以对可能预测重度 ROM 的参数进行统计学分析。
结果
体重减轻和 V30Gy（p=0.017 和 0.003）是与重度 ROM 相关的因素。ROC 曲线显示，V30 预测重度 ROM 的截断值为 73.155%（灵敏度 0.842，特异性 0.671），V30Gy 曲线下面积为 0.753（p=0.001）。
结论
通过剂量学分析发现了新的预测重度 ROM 的参数。
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