Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx.
Re-irradiation with Moderate Hypo-fractionation Using Intensity Modulated Photon or Proton Radiation Therapy in Locally Recurrent Squamous Cell Carcinoma of Nasopharynx.
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DOI：
10.4143/crt.2020.1349
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发表时间：
2022-01
影响因子：
4.6
通讯作者：
Noh JM
中科院分区：
文献类型：
--
作者：
Nam H;Ahn YC;Yang K;Oh D;Noh JM
本研究旨在分析局部复发鼻咽癌患者接受中等分割再照射（re-RT）后的治疗结果。60例局部复发的鼻咽癌患者接受了低分割再放射治疗，其中rT 3 -4者占48.3%，角化性鳞癌占30.0%。在66.7%的患者中使用了调强放射治疗（IMRT），伴或不伴调强质子治疗（IMPT）。中位随访时间为22个月（范围：2 - 254个月），分析时，31例患者（51.7%）死亡，38例（63.3%）进一步治疗失败，30例（50.0%）发生≥ 3级毒性（包括7例5级）。2年和5年总生存率、局部无失败生存率和≥ 3级无毒性生存率分别为57.9%和45.8%、64.1%和52.5%、54.8%和44.9%。在多变量分析中，总生存期（OS）的较差因素是iT 3 -4（p=0.010）和再RT时的年龄≥ 53岁（p=0.003），局部无失败生存期（LFFS）为rT 3 -4无毒性生存期（TFS）分别为iT 3 -4（p = 0.020）和re-IMRT/IMPT（p=0.030）。然而，再RT时累积剂量或分次大小≥ 3戈伊对OS、LFFS和TFS无显著性影响。采用现代RT技术，采用中等分割方案，对局部复发的鼻咽癌患者进行再放疗是可行的。
This study aimed to analyze the treatment outcomes of locally recurrent nasopharyngeal cancer (NPC) patients following moderate hypo-fractionation re-irradiation (re-RT). Sixty locally recurrent NPC patients underwent hypo-fractionation re-RT. Forty-eight point three percentage had rT3–4, and 30.0% did keratinizing squamous cell carcinoma. Intensity-modulated radiation therapy (IMRT), with or without intensity-modulated proton therapy (IMPT), was used in 66.7% of patients. With the median follow-up of 22 months (range, 2 to 254 months), 31 patients (51.7%) died, 38 (63.3%) developed further treatment failure, and 30 (50.0%) developed ≥ grade 3 toxicity (including seven grade 5) at time of analysis. The 2- and 5-year rates of overall survival, local failure-free survival, and ≥ grade 3 toxicity-free survival were 57.9% and 45.8%, 64.1% and 52.5%, and 54.8% and 44.9%, respectively. In multivariate analyses, worse factors for overall survival (OS) were iT3–4 (p=0.010) and age at re-RT ≥ 53 years (p=0.003), those for local failure-free survival (LFFS) were rT3–4 (p=0.022) and rN0–1 (p=0.035), and those for toxicity-free survival (TFS) were iT3–4 (p=0.020) and re-IMRT/IMPT (p=0.030), respectively. Cumulative dose or fraction size ≥ 3 Gy at re-RT, however, showed no significance for OS, LFFS and TFS. Current re-RT with modern RT techniques by moderate hypo-fractionation scheme seemed feasible in treating locally recurrent NPC patients.
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影响因子：
6.2
作者：
Hu J;Bao C;Gao J;Guan X;Hu W;Yang J;Hu C;Kong L;Lu JJ
通讯作者：
Lu JJ
影响因子：
3.5
作者：
Quan, Kimmen;Xu, Karen M.;Heron, Dwight E.
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Heron, Dwight E.
DOI：
10.1016/s0360-3016(97)00284-8
发表时间：
1997-08-01
影响因子：
7
作者：
Le, QTX;Fu, KK;Phillips, TL
通讯作者：
Phillips, TL
DOI：
10.1002/hed.24645
发表时间：
2017-03-01
影响因子：
2.9
作者：
Chan, Oscar S. H.;Sze, Henry C. K.;Ng, Wai Tong
通讯作者：
Ng, Wai Tong
影响因子：
6.2
作者：
Tian, Yun-ming;Zhao, Chong;Han, Fei
通讯作者：
Han, Fei