Advantages of using reduced-volume intensity modulated radiation therapy for the treatment of nasopharyngeal carcinoma: a retrospective paired study
Advantages of using reduced-volume intensity modulated radiation therapy for the treatment of nasopharyngeal carcinoma: a retrospective paired study
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DOI：
10.1186/s12885-019-5774-2
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发表时间：
2019-06-08
期刊：
影响因子：
3.8
通讯作者：
Liu, Lei
中科院分区：
文献类型：
--
作者：
Liu, Fang;Luo, Ting;Liu, Lei
背景鼻咽癌（NPC）调强放射治疗（IMRT）中临床靶区（CTV）的定义尚未得到解决。本研究旨在评估调强放疗联合减容CTV治疗鼻咽癌的可行性和疗效。方法回顾性分析2002年至2013年接受调强放疗的293例非转移性鼻咽癌患者。最终纳入180例匹配病例，其中90例接受常规调强放疗（CV-IMRT），90例接受减容调强放疗（RV-IMRT）。 Kaplan-Meier 方法和对数秩检验用于比较 NPC 特异性生存率。采用Cox比例风险模型进行多变量分析，检测独立预测因子。结果中位随访70个月，3年总生存率、无进展生存率、无远处转移生存率、局部无复发生存率、区域无复发生存率、局部区域无复发生存率分别为88.9%、84.4%、92.2%、91.1%、98.9%、91.1%。 CV-IMRT 组和 RV-IMRT 组分别为 92.2%、85.6%、90.0%、93.3%、98.9%、93.3%。没有观察到显着的生存差异。此外，与 CV-IMRT 相比，RV-IMRT 与晚期口干症 (P=0.039) 和听力损失 (P=0.008) 的风险降低相关。 结论与 CV-IMRT 相比，使用 RV-IMRT 治疗鼻咽癌的生存状况相当，并且真正减少了毒性反应。
BackgroundThe definition of clinical target volume (CTV) in intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) has not been addressed. We performed this study to assess the feasibility and efficacy of using IMRT with reduced-volume CTV for the treatment of nasopharyngeal carcinoma.MethodsWe retrospectively reviewed 293 non-metastatic NPC patients treated with IMRT from 2002 to 2013. A total of 180 matched cases finally included with 90 received conventional-volume IMRT (CV-IMRT) and 90 received reduced-volume IMRT (RV-IMRT). Kaplan-Meier method and log-rank tests were used to compare NPC-specific survival. Multivariate analyses using the Cox proportional hazards model were conducted to detect independent predictors.ResultsWith a median follow-up of 70months, the 3-year overall survival, progression-free survival, distant metastasis-free survival, local recurrence-free survival, regional recurrence-free survival, locoregional recurrence-free survival rates were 88.9, 84.4, 92.2, 91.1, 98.9, 91.1% for the CV-IMRT arm and 92.2, 85.6, 90.0, 93.3, 98.9, 93.3% for the RV-IMRT arm, respectively. None significant survival difference was observed. Additionally, RV-IMRT was associated with reduced risk of late xerostomia (P=0.039) and hearing loss (P=0.008), compared versus CV-IMRT.ConclusionsThe use of RV-IMRT for the treatment of NPC led to comparable survival condition and truly reduced toxicity reactions compared versus CV-IMRT.