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同期加量调强放疗联合同步化疗治疗鼻咽癌患者的结果。

The results of nasopharyngeal cancer patients treated by simultaneous integrated boost technique and concomitant chemotherapy.

出版信息

Turk J Med Sci. 2019 Apr 18;49(2):558-565. doi: 10.3906/sag-1605-98.

Abstract

BACKGROUND/AIM: To assess the efficacy and side effects of concurrent weekly chemotherapy and radiotherapy with simultaneous integrated boost (SIB) technique for nasopharyngeal cancer (NPC).

MATERIALS AND METHODS

total of 51 consecutive patients with diagnosis of NPC were treated between February 2010 and December 2015. The median dose for PTV70 (range: 60–82) was given in 33 fractions (range: 31–35). Forty-five of the patients received concomitant weekly chemotherapy between 3–7 cycles (median 6). Eleven patients received neoadjuvant and thirty-nine patients received adjuvant chemotherapy.

RESULTS

At a median follow-up 43 months (range: 2–76) the estimated 5-year overall survival and disease-free survival were 74.6% and 62.6%, respectively.

CONCLUSION

In radiotherapy of advanced NPC, generally a considerable amount of normal head and neck tissues might have to be irradiated in addition to gross tumor volume, involved node, and elective neck irradiation. Together with chemoradiotherapy, poor oral hygiene and inadequate nutritional support result in excessive morbidity. Despite loco-regional success of concurrent chemoradiotherapy, distant metastasis is still the major pattern of treatment failure in the intensity modulated radiotherapy era. We need to improve our adjuvant chemotherapy regimens or develop new drugs.

摘要

背景/目的:评估同期每周化疗和放疗联合同步整合升压(SIB)技术治疗鼻咽癌(NPC)的疗效和副作用。

材料和方法

2010 年 2 月至 2015 年 12 月期间,共收治了 51 例确诊为 NPC 的连续患者。PTV70 的中位剂量(范围:60-82)为 33 个分数(范围:31-35)。45 例患者接受了 3-7 个周期(中位数为 6 个)的同期每周化疗。11 例患者接受了新辅助化疗,39 例患者接受了辅助化疗。

结果

中位随访 43 个月(范围:2-76)后,估计 5 年总生存率和无病生存率分别为 74.6%和 62.6%。

结论

在治疗晚期 NPC 时,除了大体肿瘤体积、受累淋巴结和选择性颈部照射外,通常还需要对大量的正常头颈部组织进行照射。结合放化疗,不良的口腔卫生和营养支持不足会导致发病率过高。尽管调强放疗时代同期放化疗取得了局部区域的成功,但远处转移仍然是治疗失败的主要模式。我们需要改进辅助化疗方案或开发新药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26f5/7018215/6314fd03a2ae/turkjmedsci-49-558-fig001.jpg

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