Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Clinical Oncology, Shenzhen Key Laboratory for Cancer Metastasis and Personalized Therapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Radiother Oncol. 2024 Jun;195:110258. doi: 10.1016/j.radonc.2024.110258. Epub 2024 Mar 26.
This systematic review examines the role of dosimetric parameters in predicting temporal lobe necrosis (TLN) risk in nasopharyngeal carcinoma (NPC) patients treated with three-dimensional conformal RT (3D-CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). TLN is a serious late complication that can adversely affect the quality of life of NPC patients. Understanding the relationship between dosimetric parameters and TLN can guide treatment planning and minimize radiation-related complications. A comprehensive search identified relevant studies published up to July 2023. Studies reporting on dosimetric parameters and TLN in NPC patients undergoing 3D-CRT, IMRT, and VMAT were included. TLN incidence, follow-up duration, and correlation with dosimetric parameters of the temporal lobe were analyzed. The review included 30 studies with median follow-up durations ranging from 28 to 110 months. The crude incidence of TLN varied from 2.3 % to 47.3 % and the average crude incidence of TLN is approximately 14 %. Dmax and D1cc emerged as potential predictors of TLN in 3D-CRT and IMRT-treated NPC patients. Threshold values of >72 Gy for Dmax and >62 Gy for D1cc were associated with increased TLN risk. However, other factors should also be considered, including host characteristics, tumor-specific features and therapeutic factors. In conclusion, this systematic review highlights the significance of dosimetric parameters, particularly Dmax and D1cc, in predicting TLN risk in NPC patients undergoing 3D-CRT, IMRT, and VMAT. The findings provide valuable insights that can help in developing optimal treatment planning strategies and contribute to the development of clinical guidelines in this field.
这篇系统综述探讨了剂量学参数在预测接受三维适形放疗（3D-CRT）、调强放疗（IMRT）和容积旋转调强放疗（VMAT）治疗的鼻咽癌（NPC）患者颞叶坏死（TLN）风险中的作用。TLN 是一种严重的迟发性并发症，会对 NPC 患者的生活质量产生不利影响。了解剂量学参数与 TLN 之间的关系可以指导治疗计划并最大限度地减少与放疗相关的并发症。全面检索确定了截至 2023 年 7 月发表的相关研究。纳入了报告 3D-CRT、IMRT 和 VMAT 治疗 NPC 患者剂量学参数与 TLN 关系的研究。分析了 TLN 发生率、随访时间以及与颞叶剂量学参数的相关性。该综述纳入了 30 项研究，中位随访时间范围为 28 至 110 个月。TLN 的粗发生率为 2.3%至 47.3%，平均粗发生率约为 14%。3D-CRT 和 IMRT 治疗的 NPC 患者中，Dmax 和 D1cc 是 TLN 的潜在预测指标。Dmax>72Gy 和 D1cc>62Gy 与 TLN 风险增加相关。然而，还应考虑其他因素，包括宿主特征、肿瘤特征和治疗因素。总之，这项系统综述强调了剂量学参数，特别是 Dmax 和 D1cc，在预测接受 3D-CRT、IMRT 和 VMAT 治疗的 NPC 患者 TLN 风险中的重要性。研究结果为制定最佳治疗计划策略提供了有价值的见解，并有助于该领域临床指南的制定。
