Comparative analysis of acute toxicities and patient reported outcomes between intensity-modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) for the treatment of oropharyngeal cancer
Comparative analysis of acute toxicities and patient reported outcomes between intensity-modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) for the treatment of oropharyngeal cancer
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DOI：
10.1016/j.radonc.2020.03.010
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发表时间：
2020-06-01
影响因子：
5.7
通讯作者：
Foote, Robert L.
中科院分区：
文献类型：
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作者：
Manzar, Gohar S.;Lester, Scott C.;Foote, Robert L.
背景和目的：在口咽癌(OPC)的治疗中，IMPT比VMAT能更好地保留正常组织。我们的目的是评估这是否转化为临床益处。材料和方法：纳入2013-2018年间接受确定性或辅助性IMPT或VMAT治疗的OPC患者。所有患者都接受了前瞻性评估，使用患者报告的结果(PRO)(EORTCQLQ-H&N35)和提供者评估的毒性(CTCAEv4.03)。比较治疗结束时和治疗前的评分。回顾收集了插管使用、住院和麻醉使用情况。结果：46例IMPT患者和259例VMAT患者入选，中位随访期分别为12个月和30个月。除了年龄(p=0.04，impt较大)和吸烟(p0.01，10.9%impt 20PYs，29.3%vmat)外，基线特征都是平衡的。IMPT与较低的聚乙二醇置入率(OR=0.27；95%CI：0.12-0.59；p=0.001)和较少的住院有关
Background and purpose: IMPT improves normal tissue sparing compared to VMAT in treating oropharyngeal cancer (OPC). Our aim was to assess if this translates into clinical benefits.Materials and methods: OPC patients treated with definitive or adjuvant IMPT or VMAT from 2013 to 2018 were included. All underwent prospective assessment using patient-reported-outcomes (PROs) (EORTCQLQ-H&N35) and provider-assessed toxicities (CTCAEv4.03). End-of-treatment and pretreatment scores were compared. PEG-tube use, hospitalization, and narcotic use were retrospectively collected. Statistical analysis used the Wilcoxon Rank-Sum Test with propensity matching for PROs/providerassessed toxicities, and t-tests for other clinical outcomes.Results: 46 IMPT and 259 VMAT patients were included; median follow-up was 12 months (IMPT) and 30 months (VMAT). Baseline characteristics were balanced except for age (p = 0.04, IMPT were older) and smoking (p 0.01, 10.9% IMPT 20PYs, 29.3% VMAT). IMPT was associated with lower PEG placement (OR = 0.27; 95% CI: 0.12-0.59; p = 0.001) and less hospitalization