Reirradiation for Nasal Cavity or Paranasal Sinus Tumor-A Multi-Institutional Study.
Reirradiation for Nasal Cavity or Paranasal Sinus Tumor-A Multi-Institutional Study.
复制标题
鼻腔或副鼻窦肿瘤的再照射-一项多机构研究。
DOI：
10.3390/cancers13246315
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发表时间：
2021-12-16
期刊：
影响因子：
5.2
通讯作者：
Ogita M
中科院分区：
文献类型：
--
作者：
Yamazaki H;Suzuki G;Aibe N;Yasuda M;Shiomi H;Oh RJ;Yoshida K;Nakamura S;Konishi K;Ogita M
鼻腔或副鼻窦肿瘤是罕见的，治疗结果报道为所有头颈部肿瘤的一个小亚组。然而，由于其独特的解剖特征（靠近视神经通路和颅底），治疗效果和毒性应集中在这些区域。在包括放疗在内的根治性治疗后，局部复发是常见的，主要通过手术治疗。不幸的是，由于涉及到关键器官，几乎所有病例的手术都很困难。全身化疗在治疗复发性肿瘤中起着核心作用；然而，其功效不足以延长寿命。再照射具有挑战性，因为它会导致更高的毒性，但它可能提供持久的肿瘤控制，包括在没有其他治疗选择的患者中治愈和症状缓解。我们使用多机构的数据检查了这一亚组，发现再照射治疗鼻腔或鼻窦肿瘤是可行的。再照射后远端转移率较高，尤其是有淋巴结转移的患者。我们评估了鼻腔或鼻窦肿瘤再照射的疗效和毒性。我们收集并分析了多机构的再照射病例资料。78例鼻或副鼻窦肿瘤患者接受了再放射治疗。中位生存时间为20个月，中间随访10.7个月。2年局部控制率为43%，总生存率为44%。肿瘤体积（≤25 cm3）、既往放疗和再放疗间隔（≤12个月）、组织学（鳞状细胞癌）、男性和淋巴结受累是生存率差的易感因素。远处转移20例（25.6%）。22%的患者出现≥3级不良事件，其中4级5例（8.6%），5级1例（1.2%）。肿瘤位置靠近视神经通路是发生≥3级视觉毒性的重要易感因素。鼻、副鼻窦肿瘤再照射是可行和有效的。然而，不良事件，包括疾病相关的毒性，是显著的。预后因素从这项研究中浮现出来，指导多学科方法和临床试验设计。
Nasal cavity or paranasal sinus tumors are rare, with treatment outcomes reported as a small subgroup of all head and neck tumors. However, due to their unique anatomical characteristics (proximity to the optic pathway and skull base), treatment efficacy and toxicity in should be focused on those areas. After curative treatment involving radiotherapy, local recurrence is common and treated mainly through surgery. Unfortunately, surgery is difficult in almost all cases due to the critical organs involved. Systemic chemotherapy plays a central role in managing recurrent tumors; however, its efficacy is insufficient to extend longevity. Reirradiation is challenging, as it leads to higher toxicity, but it potentially offers long-lasting tumor control, including cure and symptom palliation in patients with no other remaining therapeutic options. We examined this subgroup using multi-institutional data and found that reirradiation is feasible for treating nasal cavity or paranasal sinus tumors. A relatively high distant metastasis ratio was found after reirradiation, especially in patients with lymph node metastasis. We evaluated the efficacy and toxicity of reirradiation of nasal cavity or paranasal sinus tumors. We collected and analyzed multi-institutional data of reirradiation cases. Seventy-eight patients with nasal or paranasal sinus tumors underwent reirradiation. The median survival time was 20 months with a medial follow-up of 10.7 months. The 2-year local control and overall survival rates were 43% and 44%, respectively. Tumor volume (≤25 cm3), duration between previous radiotherapy and reirradiation (≤12 months), histology (squamous cell carcinoma), male sex, and lymph node involvement were predisposing factors for poor survival. Distant metastasis was observed in 20 patients (25.6%). Grade ≥ 3 adverse events were observed in 22% of the patients, including five grade 4 (8.6%) cases and one grade 5 (1.2%) case. Tumor location adjacent to the optic pathway was a significant predisposing factor for grade ≥3 visual toxicity. Reirradiation of nasal and paranasal sinus tumors is feasible and effective. However, adverse events, including disease-related toxicities, were significant. Prognostic factors emerge from this study to guide multidisciplinary approaches and clinical trial designs.
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对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
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DOI：
10.1016/j.ijrobp.2018.05.074
发表时间：
2018-10-01
影响因子：
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作者：
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影响因子：
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DOI：
10.1002/hed.25965
发表时间：
2020-01-01
影响因子：
2.9
作者：
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通讯作者：
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DOI：
10.1002/hed.21385
发表时间：
2011-09-01
影响因子：
2.9
作者：
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