Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors.
Late toxicities after intensity-modulated radiotherapy for nasopharyngeal carcinoma: patient and treatment-related risk factors.
复制标题
DOI：
10.1038/bjc.2013.720
复制
发表时间：
2014-01-07
影响因子：
8.8
通讯作者：
Lu, T-X
中科院分区：
文献类型：
--
作者：
Zeng, L.;Tian, Y-M;Sun, X-M;Chen, C-Y;Han, F.;Xiao, W-W;Deng, X-W;Lu, T-X
关键词：
本研究的目的是分析影响调强放疗(IMRT)鼻咽癌患者晚期毒性的因素。对2003年1月至2008年2月在本中心接受调强放射治疗的789例鼻咽癌患者进行了回顾性分析。使用RTOG晚期放射发病率评分标准和不良事件通用术语标准(3.0版)对放射治疗相关并发症进行分类。233例单纯调强放疗(组1)和5 5 6例顺铂为主的化疗(组2)。中位随访时间为65个月(范围4-106个月)。2组5年主要晚期毒副作用发生率(63.2%)明显高于1组(42.0%，P<；0.001)。多因素分析显示，N类、T类和化疗是影响预后的重要因素。颞叶最大剂量(Dmax)是影响颞叶损伤的重要因素，其危险比为1.26(95%可信区间，1.18~1.35；P<；0.001)。Dmax为65.77 的284个叶的5年TLI率为0.8%，大剂量组为27.1%(P<；0.001)。Logistic回归分析显示，腮腺平均剂量增加的危险比为1.36(95%可信区间为1.21~1.53；P<；0.001)。化疗不是显著影响因素(P=0.211)。随着调强放射治疗的应用，除TLI外，放射相关并发症的发生率已有所降低。影响TLI风险的显著因素为T细胞分类、化疗和Dmax。
The objective of this study is to analyse the factors affecting late toxicity for nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT). Seven hundred and eighty-nine consecutive NPC patients treated with IMRT at our centre from January 2003 to February 2008 were retrospectively analysed. Radiotherapy-related complications were categorised using the RTOG Late Radiation Morbidity Scoring Criteria and the Common Terminology Criteria for Adverse Events (Version 3.0). Two hundred and thirty-three patients were treated with IMRT alone (group 1) and 556 patients underwent cisplatin-based chemotherapy (group 2). Median follow-up was 65 months (range, 4–106 months). The 5-year major late toxicity rate was significantly greater in group 2 than group 1 (63.2% vs 42.0%, P<0.001). Multivariate analyses showed that N category, T category and chemotherapy were significant factors. The maximal dose (Dmax) to the temporal lobe was a significant factor affecting temporal lobe injury (TLI), with a hazard ratio of 1.26 (95% confidence interval (CI), 1.18–1.35; P<0.001) per 1-Gy increase. The 5-year TLI rate increased from 0.8% for 284 lobes with Dmax <65.77 Gy to 27.1% for 176 lobes with greater doses (P<0.001). Logistic regression showed that the hazard ratio attributed to the parotid gland mean dose was 1.36 (95% CI, 1.21–1.53; P<0.001) per 1-Gy increase. Chemotherapy was not a significant factor (P=0.211). With the application of IMRT, the incidence of radiation-related complications has been reduced except for TLI. The significant factors affecting the risk of TLI included T category, chemotherapy and Dmax.
登录
查看更多内容
影响因子：
5.7
作者：
Miah, Aisha B.;Gulliford, Sarah L.;Nutting, Christopher M.
通讯作者：
Nutting, Christopher M.
DOI：
10.1016/j.ijrobp.2009.01.084
发表时间：
2010-01-01
影响因子：
7
作者：
Wong, Frank C. S.;Ng, Alice W. Y.;Tung, Stewart Y.
通讯作者：
Tung, Stewart Y.
DOI：
10.1016/j.ijrobp.2005.03.057
发表时间：
2006-01-01
影响因子：
7
作者：
Wolden, SL;Chen, WC;Zelefsky, MJ
通讯作者：
Zelefsky, MJ
影响因子：
6.2
作者：
Xiao, Wei-Wei;Huang, Shao-Min;Zhao, Chong
通讯作者：
Zhao, Chong
DOI：
10.1016/j.ijrobp.2008.05.023
发表时间：
2009-03-15
影响因子：
7
作者：
Lee, Anne W. M.;Ng, W. T.;Bentzen, Soren M.
通讯作者：
Bentzen, Soren M.