Department of Radiation Oncology, University of Tsukuba, Tsukuba, Japan.
Department of Otolaryngology, Head and Neck Surgery, University of Tsukuba, Tsukuba, Japan.
Radiat Oncol. 2023 Jun 29;18(1):106. doi: 10.1186/s13014-023-02296-3.
To evaluate proton beam therapy (PBT) in multimodal treatment for locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinus (NPSCC).
The cases in this study included T3 and T4 NPSCC without distant metastases that were treated at our center using PBT between July 2003 and December 2020. These cases were classified into 3 groups based on resectability and treatment strategy: surgery followed by postoperative PBT (group A); those indicated to be resectable, but the patient refused surgery and received radical PBT (group B); and those declared unresectable based on the extent of the tumor and treated with radical PBT (group C).
The study included 37 cases, with 10, 9 and 18 in groups A, B and C, respectively. The median follow-up period in surviving patients was 4.4 years (range 1.0-12.3 years). The 4-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 58%, 43% and 58% for all patients; 90%, 70% and 80% in group A, 89%, 78% and 89% in group B; and 24%, 11% and 24% in group C. There were significant differences in OS (p = 0.0028) and PFS (p = 0.009) between groups A and C; and in OS (p = 0.0027), PFS (p = 0.0045) and LC (p = 0.0075) between groups B and C.
PBT gave favorable outcomes in multimodal treatment for resectable locally advanced NPSCC, including surgery followed by postoperative PBT and radical PBT with concurrent chemotherapy. The prognosis for unresectable NPSCC was extremely poor, and reconsideration of treatment strategies, such as more active use of induction chemotherapy, may improve outcomes.
评估质子束疗法（PBT）在局部晚期鼻腔和鼻窦鳞状细胞癌（NPSCC）的多模态治疗中的作用。
本研究纳入 2003 年 7 月至 2020 年 12 月在我院接受 PBT 治疗的无远处转移的 T3 和 T4 NPSCC 患者。根据可切除性和治疗策略将这些患者分为 3 组：手术+术后 PBT（A 组）；可切除，但患者拒绝手术并接受根治性 PBT（B 组）；以及根据肿瘤范围判断为不可切除并接受根治性 PBT（C 组）。
研究共纳入 37 例患者，A、B 和 C 组分别为 10、9 和 18 例。生存患者的中位随访时间为 4.4 年（1.0-12.3 年）。所有患者的 4 年总生存率（OS）、无进展生存率（PFS）和局部控制率（LC）分别为 58%、43%和 58%；A 组分别为 90%、70%和 80%；B 组分别为 89%、78%和 89%；C 组分别为 24%、11%和 24%。A 组和 C 组的 OS（p=0.0028）和 PFS（p=0.009）差异有统计学意义；B 组和 C 组的 OS（p=0.0027）、PFS（p=0.0045）和 LC（p=0.0075）差异也有统计学意义。
对于可切除的局部晚期 NPSCC，PBT 联合手术或同步放化疗的多模态治疗可获得良好的结果。对于不可切除的 NPSCC，预后极差，重新考虑治疗策略，如更积极地使用诱导化疗，可能会改善预后。
