Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma
Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma
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DOI：
10.1016/j.ijrobp.2005.07.968
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发表时间：
2006-02-01
影响因子：
7
通讯作者：
Au, G
中科院分区：
文献类型：
--
作者：
Kwong, DLW;Sham, JST;Au, G
目的：研究剂量递增治疗局部晚期鼻咽癌（NPC）的安全性和有效性。方法和材料：2000年9月至2004年6月，对50例T3-T4鼻咽癌患者进行调强放疗（IMRT）。 14 名患者患有 III 期疾病，36 名患者患有 IVA-IVB 期疾病。处方剂量为大体肿瘤体积 (GTV) 76 Gy、计划靶区 (PTV) 70 Gy 和扩大颈淋巴结 (GTVn) 72 Gy。所有剂量均在 7 周内分 35 次给药。 34 名患者还同时接受顺铂和诱导或辅助 PF（顺铂和 5-氟尿嘧啶）。 结果：GTV、GTVn 和 PTV 中获得的平均平均剂量分别为 79.5 Gy、75.3 Gy 和 74.6 Gy。中位随访时间为 25 个月，有 4 例复发：2 例局部失败，2 例远处失败。所有复发患者均仅接受调强放疗（IMRT），未进行化疗。 2年局部控制率、无远处转移和无病生存率分别为95.7%、94.2%和93.1%。发生 1 例因辅助化疗导致的治疗相关死亡。 2年总生存率为92.1%。结论：对于T3-T4鼻咽癌，肿瘤剂量增加至76 Gy是可行的，并且可以与化疗相结合。初步结果显示良好的局部控制和存活率。 (C) 2006 爱思唯尔公司。
Purpose: To study the safety and efficacy of dose escalation in tumor for locally advanced nasopharyngeal carcinoma (NPC).Methods and Materials: From September 2000 to June 2004, 50 patients with T3-T4 NPC were treated with intensity-modulated radiotherapy (IMRT). Fourteen patients had Stage III and 36 patients had Stage IVA-IVB disease. The prescribed dose was 76 Gy to gross tumor volume (GTV), 70 Gy to planning target volume (PTV), and 72 Gy to enlarged neck nodes (GTVn). All doses were given in 35 fractions over 7 weeks. Thirty-four patients also had concurrent cisplatin and induction or adjuvant PF (cisplatin and 5-fluorouracil).Results: The average mean dose achieved in GTV, GTVn, and PTV were 79.5 Gy, 75.3 Gy, and 74.6 Gy, respectively. The median follow-up was 25 months, with 4 recurrences: 2 locoregional and 2 distant failures. All patients with recurrence had IMRT alone without chemotherapy. The 2-year locoregional control rate, distant metastases-free and disease-free survivals were 95.7%, 94.2%, and 93.1%, respectively. One treatment-related death caused by adjuvant chemotherapy occurred. The 2-year overall survival was 92.1%.Conclusions: Dose escalation to 76 Gy in tumor is feasible with T3-T4 NPC and can be combined with chemotherapy. Initial results showed good local control and survival. (C) 2006 Elsevier Inc.