EXTERNAL BEAM RADIOTHERAPY WITH ENDOCAVITARY BOOST FOR NASOPHARYNGEAL CANCER: TREATMENT RESULTS AND LATE TOXICITY AFTER EXTENDED FOLLOW-UP
EXTERNAL BEAM RADIOTHERAPY WITH ENDOCAVITARY BOOST FOR NASOPHARYNGEAL CANCER: TREATMENT RESULTS AND LATE TOXICITY AFTER EXTENDED FOLLOW-UP
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DOI：
10.1016/j.ijrobp.2009.08.072
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发表时间：
2010-11-01
影响因子：
7
通讯作者：
Kaanders, Johannes H. A. M.
中科院分区：
文献类型：
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作者：
Schinagl, Dominic A. X.;Marres, Henri A. M.;Kaanders, Johannes H. A. M.
目的：为了评估鼻咽癌治疗后的长期结果，并评估在一个多学科clinic.Methods和材料的晚期毒性：117例鼻咽癌患者治疗在一个单一的研究所1985年和2002年之间进行了回顾性分析。五十一个长期的幸存者进行了评估，由一个多学科的团队，包括放射肿瘤学家，耳鼻喉科医生，神经科医生，口腔颌面surgeon.Results：T1至T2和T3至T4肿瘤的5年局部控制率分别为97%和76%，晚期毒性。I期至IIb期疾病的5年无病生存率和总生存率分别为82%和88%，III期至IVb期疾病的5年无病生存率和总生存率分别为46%和52%。晚期发病率评估显示，71%的患者出现放射治疗肿瘤学组（RTOG）III至IV级毒性。颅神经麻痹（47%）和下颌骨溶解（82%）的高发病率被发现，虽然这些并发症有有限的临床impacts.Conclusions：多学科的晚期发病率诊所揭示了一个意想不到的高发病率颅神经麻痹和下颌骨溶解和整体RTOG III级至IV级毒性71%的鼻咽癌治疗的患者。体外放射治疗结合腔内近距离放射治疗对T1 ~ T2期肿瘤的局部控制率很高，但晚期毒性的发生率很高，提示过度治疗。(C)2010年爱思唯尔公司
Purpose: To evaluate the long-term outcome after treatment of nasopharyngeal carcinoma and assess late toxicity in a multidisciplinary clinic.Methods and Materials: A retrospective analysis of 117 patients treated for nasopharyngeal cancer in a single institute between 1985 and 2002 was performed. Fifty-one long-term survivors were evaluated for late toxicity by a multidisciplinary team comprising a radiation oncologist, otolaryngologist, neurologist, and oral and maxillofacial surgeon.Results: The 5-year local control rate for T1 to T2 and T3 to T4 tumors was 97% and 76%, respectively. Five-year disease-free survival and overall survival were 82% and 88% for Stage I to lib disease and 46% and 52% for Stage III to IVb, respectively. Late morbidity evaluation revealed Radiation Therapy Oncology Group (RTOG) Grade III to IV toxicity in 71% of patients. A high incidence of cranial nerve palsies (47%) and mandibular osteolysis (82%) was found, although these complications had limited clinical impact.Conclusions: The multidisciplinary late morbidity clinic revealed an unexpected high incidence of cranial nerve palsies and mandibular osteolysis and overall an RTOG Grade III to IV toxicity in 71% of patients treated for nasopharyngeal cancer. External beam radiotherapy with endocavitary brachytherapy produces excellent rates of local control for T1 to T2 tumors, but the high incidence of late toxicity suggests an overtreatment. (C) 2010 Elsevier Inc.