Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma.
Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma.
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儿童和青少年鼻咽癌同时整合升压调强放疗的长期结果和晚期毒性
DOI：
10.5732/cjc.013.10124
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发表时间：
2013-10
影响因子：
--
通讯作者：
Sun Y
中科院分区：
文献类型：
--
作者：
Tao CJ;Liu X;Tang LL;Mao YP;Chen L;Li WF;Yu XL;Liu LZ;Zhang R;Lin AH;Ma J;Sun Y
同步综合增强强度调制放疗（sibt - imrt）在儿童和青少年鼻咽癌（NPC）中的应用被低估。本研究旨在评估儿童和青少年鼻咽癌患者在sibb - imrt联合化疗后的长期预后和晚期毒性。34例组织学证实的非播散性鼻咽癌患者（年龄8-20岁）接受了sibb - imrt治疗，纳入了这项回顾性研究。疾病分期分布如下：I期1例（2.9%）；III期14例（41.2%）；IV期19例（55.9%）。所有患者均接受了sibb - imrt， 30例患者还接受了以顺铂为基础的化疗。IMRT的处方剂量为64-68 Gy，按29-31次分次至鼻咽总靶体积。中位随访52个月（范围9-111个月），1例（2.9%）局部复发，4例（11.8%）发生远处转移（3例肺转移，1例多器官转移）。4例（11.8%）因复发或转移死亡。5年局部无复发生存率、远处无转移生存率、无病生存率和总生存率分别为97.1%、88.2%、85.3%和88.2%。最常见的急性毒性是3-4级血液毒性和口腔炎。在24例存活超过2年的患者中，16例（66.7%）和15例（62.5%）分别发生1-2级口干和耳毒性。2例（8.3%）出现3级耳毒性；未观察到4级毒性。sibb - imrt联合化疗在儿童和青少年鼻咽癌中获得了良好的长期局部控制，晚期毒性发生率低。远处转移是主要的失败模式。
The application of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in pediatric and adolescent nasopharyngeal carcinoma (NPC) is underevaluated. This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy. Thirty-four patients (aged 8–20 years) with histologically proven, non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study. The disease stage distribution was as follows: stage I, 1 (2.9%); stage III, 14 (41.2%); and stage IV, 19 (55.9%). All patients underwent SIB-IMRT and 30 patients also underwent cisplatin-based chemotherapy. The prescribed dose of IMRT was 64–68 Gy in 29–31 fractions to the nasopharyngeal gross target volume. Within the median follow-up of 52 months (range, 9–111 months), 1 patient (2.9%) experienced local recurrence and 4 (11.8%) developed distant metastasis (to the lung in 3 cases and to multiple organs in 1 case). Four patients (11.8%) died due to recurrence or metastasis. The 5-year locoregional relapse–free survival, distant metastasis–free survival, disease-free survival, and overall survival rates were 97.1%, 88.2%, 85.3%, and 88.2%, respectively. The most common acute toxicities were grades 3–4 hematologic toxicities and stomatitis. Of the 24 patients who survived for more than 2 years, 16 (66.7%) and 15 (62.5%) developed grades 1–2 xerostomia and ototoxicity, respectively. Two patients (8.3%) developed grade 3 ototoxicity; no grade 4 toxicities were observed. SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC, with mild incidence of late toxicities. Distant metastasis is the predominant mode of failure.
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DOI：
10.1016/j.ijrobp.2008.05.028
发表时间：
2009-03-15
影响因子：
7
作者：
Varan, Ali;Oezyar, Enis;Bueyuekpamukcu, Muenevver
通讯作者：
Bueyuekpamukcu, Muenevver
影响因子：
5.7
作者：
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通讯作者：
Atahan, Ibtisam Lale
影响因子：
158.5
作者：
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通讯作者：
Lefebvre, Jean-Louis
DOI：
10.1016/j.ijrobp.2005.07.968
发表时间：
2006-02-01
影响因子：
7
作者：
Kwong, DLW;Sham, JST;Au, G
通讯作者：
Au, G
影响因子：
6.2
作者：
Xiao, Wei-Wei;Huang, Shao-Min;Zhao, Chong
通讯作者：
Zhao, Chong