Widikusumo Arundito, Purnamawati Schandra
Department of Radiotherapy, Prof. Dr. Margono Soekarjo General Hospital, Purwokerto, Indonesia.
Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia.
Contemp Oncol (Pozn). 2019;23(3):127-132. doi: 10.5114/wo.2019.89240. Epub 2019 Oct 30.
Standard therapy for nasopharyngeal cancer (NPC) is concurrent chemoradiation. Nevertheless, therapeutic outcomes are often unsatisfactory particularly for locally advanced stage. To enhance the therapeutic outcome, we may consider using altered fraction radiotherapy. Altered fraction radiotherapy is divided into two large groups for the therapy of NPC: hyperfraction radiotherapy and accelerated fraction radiotherapy. One of the accelerated fraction regimens suitable for NPC therapy is an accelerated regimen of six radiotherapy fractions weekly. This regimen is considered safe whether using conventional 2D planning technique or advance technique. Response to radiotherapy is better owing to the decrease in overall treatment time (OTT). Furthermore, acute or late side effects for this therapy are not very different to those of standard therapy. The conclusion is that we recommend the use of an accelerated regimen of six radiotherapy fractions weekly for locally advanced stage NPC with contraindication to concurrent chemoradiation, due to the high degree of clinical outcome as well as better tolerated side effect for NPC patients, particularly for those with locally advanced stage NPC.
鼻咽癌(NPC)的标准治疗方法是同步放化疗。然而,治疗效果往往不尽人意,尤其是对于局部晚期患者。为了提高治疗效果,我们可以考虑采用改变分割放疗。改变分割放疗在NPC治疗中分为两大类:超分割放疗和加速分割放疗。适用于NPC治疗的加速分割方案之一是每周进行六次放疗的加速方案。无论使用传统的二维计划技术还是先进技术,该方案都被认为是安全的。由于总治疗时间(OTT)的减少,放疗反应更好。此外,该治疗的急性或晚期副作用与标准治疗的副作用没有太大差异。结论是,对于有同步放化疗禁忌证的局部晚期NPC患者,我们推荐使用每周六次放疗的加速方案,因为该方案对NPC患者具有高度的临床疗效以及更好的耐受性副作用,特别是对于那些局部晚期NPC患者。