Yamazaki Hideya, Suzuki Gen, Aibe Norihiro, Yasuda Makoto, Shiomi Hiroya, Oh Ryoong-Jin, Yoshida Ken, Nakamura Satoaki, Konishi Koji, Ogita Mikio
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Cancers (Basel). 2021 Dec 16;13(24):6315. doi: 10.3390/cancers13246315.
We evaluated the efficacy and toxicity of reirradiation of nasal cavity or paranasal sinus tumors. We collected and analyzed multi-institutional data of reirradiation cases. Seventy-eight patients with nasal or paranasal sinus tumors underwent reirradiation. The median survival time was 20 months with a medial follow-up of 10.7 months. The 2-year local control and overall survival rates were 43% and 44%, respectively. Tumor volume (≤25 cm), duration between previous radiotherapy and reirradiation (≤12 months), histology (squamous cell carcinoma), male sex, and lymph node involvement were predisposing factors for poor survival. Distant metastasis was observed in 20 patients (25.6%). Grade ≥ 3 adverse events were observed in 22% of the patients, including five grade 4 (8.6%) cases and one grade 5 (1.2%) case. Tumor location adjacent to the optic pathway was a significant predisposing factor for grade ≥3 visual toxicity. Reirradiation of nasal and paranasal sinus tumors is feasible and effective. However, adverse events, including disease-related toxicities, were significant. Prognostic factors emerge from this study to guide multidisciplinary approaches and clinical trial designs.
我们评估了鼻腔或鼻窦肿瘤再程放疗的疗效和毒性。我们收集并分析了多机构再程放疗病例的数据。78例鼻腔或鼻窦肿瘤患者接受了再程放疗。中位生存时间为20个月,中位随访时间为10.7个月。2年局部控制率和总生存率分别为43%和44%。肿瘤体积(≤25 cm)、上次放疗与再程放疗之间的间隔时间(≤12个月)、组织学类型(鳞状细胞癌)、男性以及淋巴结受累是生存不良的易感因素。20例患者(25.6%)出现远处转移。22%的患者观察到≥3级不良事件,包括5例4级(8.6%)和1例5级(1.2%)。肿瘤位置毗邻视路是≥3级视觉毒性的显著易感因素。鼻腔和鼻窦肿瘤的再程放疗是可行且有效的。然而,包括疾病相关毒性在内的不良事件较为显著。本研究得出了预后因素,以指导多学科治疗方法和临床试验设计。