Salvage treatment using carbon ion radiation in patients with locoregionally recurrent nasopharyngeal carcinoma: Initial results.
Salvage treatment using carbon ion radiation in patients with locoregionally recurrent nasopharyngeal carcinoma: Initial results.
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作者：
Hu J;Bao C;Gao J;Guan X;Hu W;Yang J;Hu C;Kong L;Lu JJ
局部复发性鼻咽癌（NPC）在接受一定剂量的放疗（RT）后进行再放疗具有挑战性，并且通常与严重的毒性相关。强度调制碳离子 RT (IMCT) 比基于光子的强度调制 RT 具有物理/生物优势。在此，作者报告了他们对既往接受过放射治疗的局部复发性鼻咽癌患者进行 IMCT 的初步经验。本研究纳入2015年5月至2017年8月期间在上海质子重离子中心接受IMCT抢救治疗的局部复发、低分化或未分化鼻咽癌患者。 IMCT 剂量为 50 至 66 戈瑞当量 (GyE)（2.0-3.0 GyE/每日分数），通过光栅扫描技术提供。计算1年总生存率、疾病特异性生存率、无进展生存率（PFS）、局部无复发生存率、区域无复发生存率和无远处转移生存率。对 PFS 进行单变量和多变量分析以确定可能的预测因素。在这 75 名患者中，分别有 4 名患者、14 名患者、29 名患者和 28 名患者患有美国癌症联合委员会复发性 I 期、II 期、III 期和 IVA/B 期疾病。中位随访时间为15.4个月（范围为2.6-29.7个月），1年总生存率、疾病特异性生存率、PFS、局部无复发生存率、区域无复发生存率和无远处转移生存率分别为98.1%、98.1%、82.2%、86.6%、97.9%和96.2%。 3 GyE 的较高分次大小（相对于 <3 GyE）或较高的生物等效剂量可显着提高单变量分析的 PFS 率，但在多变量分析中则不然。 IMCT 期间没有患者出现≥2 级的急性毒性。晚期治疗引起的严重（3 级或 4 级）毒性并不常见，但包括粘膜坏死（9.3%）、口干症（1.3%）和颞叶坏死（1.3%）。前 75 名局部复发性鼻咽癌患者的初步经验令人鼓舞。碳离子放疗可以为局部复发性鼻咽癌患者提供有希望的生存率和罕见的严重毒性。癌症 2018；124：2427-37。 © 2018 作者。 《癌症》由 Wiley periodicals, Inc. 代表美国癌症协会出版。局部复发性鼻咽癌在接受一定剂量的放射治疗后进行再放射治疗具有挑战性，并且通常与严重的毒性相关。碳离子放射治疗为局部复发鼻咽癌患者提供了有希望的短期生存率，并且几乎没有注意到治疗引起的严重不良反应。
Reirradiation for locoregionally recurrent nasopharyngeal carcinoma (NPC) after a definitive dose of radiotherapy (RT) is challenging and usually associated with severe toxicities. Intensity‐modulated carbon ion RT (IMCT) offers physical/biologic advantages over photon‐based intensity‐modulated RT. Herein, the authors report their initial experience of IMCT in previously irradiated patients with locoregionally recurrent NPC. Patients with locoregionally recurrent, poorly differentiated or undifferentiated NPC who underwent salvage therapy with IMCT at the Shanghai Proton and Heavy Ion Center between May 2015 and August 2017 were included in the current study. The IMCT doses were 50 to 66 Gray equivalent (GyE) (2.0‐3.0 GyE/daily fraction), delivered via raster scanning technology. The 1‐year overall survival, disease‐specific survival, progression‐free survival (PFS), local recurrence‐free survival, regional recurrence‐free survival, and distant metastasis‐free survival were calculated. Univariate and multivariate analyses of PFS were performed to identify possible predictive factors. Among the 75 patients included, 4 patients, 14 patients, 29 patients, and 28 patients, respectively, had recurrent American Joint Committee on Cancer stage I, stage II, stage III, and stage IVA/B disease. With a median follow‐up of 15.4 months (range, 2.6‐29.7 months), the 1‐year overall survival, disease‐specific survival, PFS, local recurrence‐free survival, regional recurrence‐free survival, and distant metastasis‐free survival rates were 98.1%, 98.1%, 82.2%, 86.6%, 97.9%, and 96.2%, respectively. A higher fraction size of 3 GyE (vs <3 GyE) or a higher biological equivalent dose significantly improved the PFS rate on univariate analysis, but not on multivariate analysis. No patient developed acute toxicity of grade ≥2 during IMCT. Late treatment‐induced severe (grade 3 or 4) toxicities were infrequent, but included mucosal necrosis (9.3%), xerostomia (1.3%), and temporal lobe necrosis (1.3%). This initial experience in the first 75 patients with locoregionally recurrent NPC was encouraging. Carbon ion RT could provide promising survival rates with infrequent severe toxicities for patients with locoregionally recurrent NPC. Cancer 2018;124:2427‐37. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Reirradiation for locoregionally recurrent nasopharyngeal carcinoma after a definitive dose of radiotherapy is challenging and usually associated with severe toxicities. Carbon ion radiotherapy provides promising short‐term survival rates for patients with locoregionally recurrent nasopharyngeal carcinoma, with few treatment‐induced severe adverse effects noted.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
4.6
作者：
Kong L;Wang L;Shen C;Hu C;Wang L;Lu JJ
通讯作者：
Lu JJ
影响因子：
3.5
作者：
Nieder, C;Milas, L;Ang, KK
通讯作者：
Ang, KK
影响因子：
--
作者：
Islam, M. Amirul;Yanagi, Takeshi;Tsujii, Hirohiko
通讯作者：
Tsujii, Hirohiko
DOI：
10.1007/s00405-010-1385-x
发表时间：
2010-12
期刊：
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
影响因子：
--
作者：
Suárez C;Rodrigo JP;Rinaldo A;Langendijk JA;Shaha AR;Ferlito A
通讯作者：
Ferlito A