容积旋转调强放疗对比调强放疗治疗鼻咽癌患者的生活质量和生存结果。
Quality of life and survival outcome for patients with nasopharyngeal carcinoma treated by volumetric-modulated arc therapy versus intensity-modulated radiotherapy.
机构信息
Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
出版信息
Radiat Oncol. 2020 Apr 19;15(1):84. doi: 10.1186/s13014-020-01532-4.
BACKGROUND
To evaluate the longitudinal changes of quality of life (QoL) and survival in patients with nasopharyngeal carcinoma (NPC) treated by volumetric-modulated arc therapy (VMAT) versus intensity-modulated radiotherapy (IMRT).
METHODS
One hundred and forty non-distant metastatic NPC patients treated by VMAT (n = 66) or IMRT (n = 74) with simultaneously integrated boost between March 2013 and December 2015 at a single institute were analyzed. QoL was prospectively assessed by the EORTC QLQ-C30 and HN35 questionnaires at the four time points: before RT, RT 42.4 Gy (20 fractions), and 3, 12 months after RT.
RESULTS
The 3-year locoregional relapse-free survival, distant metastasis-free survival, failure-free survival, and overall survival rates were 96.6, 89.4, 86.1%, and 87.4 for the VMAT group, respectively, compared with 91.4, 90.0, 79.8, and 91.3% for the IMRT group (p value > 0.05). The pattern of QoL changes was similar between the VMAT and IMRT group. No statistically or clinically significant difference in all the QoL scales was observed between VMAT and IMRT group at each time point. Compared to before RT, we observed statistically (p<0.05) and clinically (difference of mean scores≧10) better outcome in global QoL and social functioning, but worse head and neck symptomatic outcome in swallowing, taste/smell, opening mouth, dry mouth, and sticky saliva at the time point of 1 year after RT for both groups.
CONCLUSION
The study provides the evidence that the tumor control, survival and changes of QoL is compatible for NPC patients treated by VMAT versus IMRT.
背景
评估容积调强弧形治疗（VMAT）与调强放疗（IMRT）治疗鼻咽癌（NPC）患者的生活质量（QoL）和生存的纵向变化。
方法
对 2013 年 3 月至 2015 年 12 月在单一机构接受 VMAT（n=66）或 IMRT（n=74）同步加量调强治疗的 140 例无远处转移 NPC 患者进行分析。在四个时间点（放疗前、放疗 42.4Gy（20 个分次）、放疗后 3 个月和 12 个月）通过 EORTC QLQ-C30 和 HN35 问卷前瞻性评估 QoL。
结果
VMAT 组 3 年局部区域无复发生存率、远处无转移生存率、无失败生存率和总生存率分别为 96.6%、89.4%、86.1%和 87.4%，IMRT 组分别为 91.4%、90.0%、79.8%和 91.3%（p 值>0.05）。VMAT 组和 IMRT 组的 QoL 变化模式相似。在每个时间点，VMAT 组和 IMRT 组在所有 QoL 量表上均未观察到统计学或临床意义上的差异。与放疗前相比，两组患者在放疗后 1 年时，在总体 QoL 和社会功能方面均观察到统计学上（p<0.05）和临床上（平均评分差值≥10）更好的结果，而在吞咽、味觉/嗅觉、张口、口干和口涎粘稠方面的头颈部症状则更差。
结论
该研究为 VMAT 与 IMRT 治疗 NPC 患者的肿瘤控制、生存和 QoL 变化提供了证据，两者是一致的。
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