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容积调强弧形放疗同步化疗治疗局部晚期鼻咽癌患者的临床疗效

Clinical outcomes of concurrent chemoradiotherapy with volumetric modulated arc therapy in patients with locally advanced nasopharyngeal carcinoma.

作者信息

Imano Nobuki, Murakami Yuji, Nakashima Takeo, Takeuchi Yuki, Takahashi Ippei, Doi Yoshiko, Nishibuchi Ikuno, Kimura Tomoki, Wadasaki Koichi, Ueda Tsutomu, Hirakawa Katsuhiro, Nagata Yasushi

机构信息

Department of Radiation Oncology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Department of Radiation Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan.

出版信息

Jpn J Radiol. 2017 Nov;35(11):673-680. doi: 10.1007/s11604-017-0680-5. Epub 2017 Sep 8.

Abstract

PURPOSE

The purpose of this study was to analyze the clinical results of concurrent chemoradiotherapy (CCRT) with volumetric modulated arc therapy (VMAT) for nasopharyngeal carcinoma (NPC) patients.

MATERIALS AND METHODS

Patients with stage II-IVB NPC who received CCRT with VMAT between 2010 and 2014 were included in this study. The planned dose was 70 Gy in 35 fractions.

RESULTS

Twenty patients aged between 28 and 85 years (median 60 years) were assessed. With a median follow-up time of 47 months, the 3-year overall survival and progression-free survival rates were 85 and 65%, respectively. The 3-year local, regional and distant control rates were 78, 88 and 79%, respectively. At 0, 3, 6 and 12 months from CCRT, 19, 6, 3, and 1 patients had grade 2 dry mouth, respectively. No cases of grade 3 or worse dry mouth were observed. The severity of dry mouth was downgraded from grade 2 to grade 0 or 1 significantly earlier in younger patients (<70 years, p = 0.02) or patients in whom the mean dose to one parotid gland was lower (<26 Gy, p = 0.04).

CONCLUSIONS

Our clinical results regarding CCRT with VMAT for NPC patients showed favorable survival rates while maintaining organ function.

摘要

目的

本研究旨在分析容积调强弧形放疗(VMAT)同步放化疗(CCRT)治疗鼻咽癌(NPC)患者的临床效果。

材料与方法

本研究纳入了2010年至2014年间接受VMAT同步放化疗的II-IVB期NPC患者。计划剂量为70 Gy,分35次给予。

结果

评估了20例年龄在28至85岁(中位年龄60岁)之间的患者。中位随访时间为47个月,3年总生存率和无进展生存率分别为85%和65%。3年局部、区域和远处控制率分别为78%、88%和79%。在同步放化疗后的0、3、6和12个月时,分别有19、6、3和1例患者出现2级口干。未观察到3级或更严重口干的病例。年轻患者(<70岁,p = 0.02)或一侧腮腺平均剂量较低的患者(<26 Gy,p = 0.04)口干严重程度从2级显著降至0级或1级的时间更早。

结论

我们关于VMAT同步放化疗治疗NPC患者的临床结果显示,在维持器官功能的同时生存率良好。

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