Wu LiPing, He JianPing, Zheng YuQing, Li Yang
Department of Otolaryngology, Huzhou Central Hospital, Huzhou, Zhejiang, 313000, China.
Department of Otolaryngology, The 910th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Quanzhou, Fujian, 362000, China.
Open Med (Wars). 2024 Jan 16;19(1):20230842. doi: 10.1515/med-2023-0842. eCollection 2024.
To compare target area delineation schemes in intensity-modulated radiotherapy (IMRT) effect on patients with locally advanced nasopharyngeal carcinoma (NPC).
A total of 88 NPC patients received IMRT and were assigned into control group ( = 44) and observation group ( = 44) based on MRI and CT imaging. In the control group, the treatment range was determined as the clinical target volume (CTV) as the gross tumor volume (GTV) + 5 mm. In the observation group, high-risk target areas CTVp1 was GTVp + 5 mm, lymphatic drainage area CTVn1 was GTVn + 5 mm, medium-risk CTVp2 was CTVp1 + 5 mm margin + the whole nasopharyngeal area, CTVn2 was CTVn1 + 5 mm. Radiotherapy treatment course was 6-8 weeks, four times a week.
The observation group had higher total effective rate, with fewer complications. Neutrophil lymphocyte ratio (NLR), interleukin (IL)-6, and tumor necrosis factor (TNF)-α levels were lower after radiotherapy in both groups compared to before radiotherapy, with the observation group demonstrating lower levels than the control group. The effective group exhibited lower serum NLR, IL-6, and TNF-α compared to the non-effective group. T stage, target location, serum NLR, IL-6, and TNF-α were risk factors for the effect of radiotherapy.
Serum NLR, IL-6, and TNF-α have predictive significance for radiotherapy effect.
比较调强放射治疗（IMRT）中靶区勾画方案对局部晚期鼻咽癌（NPC）患者的影响。
88例NPC患者接受IMRT治疗，根据MRI和CT影像分为对照组（ = 44）和观察组（ = 44）。对照组治疗范围确定为临床靶体积（CTV）即大体肿瘤体积（GTV）+ 5 mm。观察组中，高危靶区CTVp1为GTVp + 5 mm，淋巴引流区CTVn1为GTVn + 5 mm，中危CTVp2为CTVp1 + 5 mm边界+整个鼻咽区域，CTVn2为CTVn1 + 5 mm。放射治疗疗程为6 - 8周，每周4次。
观察组总有效率更高，并发症更少。两组放疗后中性粒细胞淋巴细胞比值（NLR）、白细胞介素（IL）-6和肿瘤坏死因子（TNF）-α水平均低于放疗前，且观察组低于对照组。有效组血清NLR、IL-6和TNF-α水平低于无效组。T分期、靶区位置、血清NLR、IL-6和TNF-α是放疗效果的危险因素。
血清NLR、IL-6和TNF-α对放疗效果具有预测意义。
