Reirradiation with intensity-modulated radiotherapy for locally recurrent T3 to T4 nasopharyngeal carcinoma
Reirradiation with intensity-modulated radiotherapy for locally recurrent T3 to T4 nasopharyngeal carcinoma
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DOI：
10.1002/hed.24645
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发表时间：
2017-03-01
影响因子：
2.9
通讯作者：
Ng, Wai Tong
中科院分区：
文献类型：
--
作者：
Chan, Oscar S. H.;Sze, Henry C. K.;Ng, Wai Tong
背景。本研究的目的是评估调强放疗 (IMRT) 对局部晚期复发性鼻咽癌 (NPC) 患者进行再放疗的疗效和毒性。方法。回顾性分析2005年至2013年间接受治疗的38例连续rT3至rT4鼻咽癌患者。结果。 3年总生存率（OS）、无进展生存率（PFS）和局部控制率分别为47.2%、17.5%和44.3%。总目标体积 (GTV) D-95、GTV D-50 和年龄都是 OS 和 PFS 的重要预后因素，但只有 GTV D-95 是局部控制的重要决定因素。总共 73.7% 的患者经历了≥1 次 3 级晚期毒性，3 名患者死于大量鼻出血。总生物当量剂量越高，颞叶坏死（TLN）发生得越早。结论。足够的肿瘤剂量覆盖对于治疗 rT3 至 rT4 NPC 很重要。尽管晚期并发症很常见，但与治疗相关的死亡率本质上只是血管性的。应根据晚期毒性的最新信息修改神经结构再照射的剂量限制。 (C) 2016 年 Wiley 期刊公司。
Background. The purpose of this study was to assess the efficacy and toxicities of reirradiation using intensity-modulated radiotherapy (IMRT) in patients with locally advanced recurrent nasopharyngeal carcinoma (NPC).Methods. Thirty-eight patients with consecutive rT3 to rT4 NPC treated between 2005 and 2013 were retrospectively analyzed.Results. The 3-year overall survival (OS), progression-free survival (PFS), and local control rate were 47.2%, 17.5%, and 44.3%, respectively. Gross target volume (GTV) D-95, GTV D-50, and age were all important prognostic factors for OS and PFS, but only GTV D-95 was an important determinant for local control. A total of 73.7% patients experienced >= 1 grade 3 late toxicities and 3 patients died of massive epistaxis. Temporal lobe necrosis (TLN) developed sooner with a higher total biological equivalent dose.Conclusion. Adequate tumor dose coverage was important for treating rT3 to rT4 NPC. Although late complications were common, treatment-related mortality was solely vascular in nature. Dose constraints of neurologic structures for reirradiation should be revised with the latest information on late toxicities. (C) 2016 Wiley Periodicals, Inc.