A Two-step Intensity-modulated Radiation Therapy Method for Nasopharyngeal Cancer: The Kinki University Experience
A Two-step Intensity-modulated Radiation Therapy Method for Nasopharyngeal Cancer: The Kinki University Experience
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DOI：
10.1093/jjco/hyp136
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发表时间：
2010-02-01
影响因子：
2.4
通讯作者：
Okumura, Masahiko
中科院分区：
文献类型：
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作者：
Nishimura, Yasumasa;Shibata, Toru;Okumura, Masahiko
本研究的目的是分析近畿大学医院鼻咽癌（NPC）适应性放射治疗方案两步调强放射治疗（IMRT）方法的临床结果。2000年至2007年间，纳入了35例接受IMRT治疗的I-IVB期鼻咽癌患者。对于所有患者，在 IMRT 之前和期间进行了两次治疗计划计算机断层扫描，总剂量为 60-70 Gy/28-35 次（中位 68 Gy）。 31例患者同时接受化疗（顺铂80 mg/m(2)/3周×1-3个疗程）与IMRT。31例同步化疗患者的3年和5年总生存率分别为88%和83%。 31 名患者的 3 年和 5 年局部区域控制率分别为 93% 和 87%。对于三名早期病例，原发部位或受累淋巴结的规划靶区描绘不够充分，导致三名患者出现边缘复发（9%）。除一名患者早亡外，1-2岁时口干评分为：0级、11级；一年级、17岁；二、五年级； 3级，1级。尽管在一些早期病例中注意到边缘复发，但通过两步IMRT方法与同步化疗的鼻咽癌获得了优异的总生存率和局部区域控制率。
The aim of this study was to analyze the clinical results of our adaptive radiation therapy scheme of a two-step intensity-modulated radiotherapy (IMRT) method for nasopharyngeal cancer (NPC) at Kinki University Hospital.Between 2000 and 2007, 35 patients with Stage I-IVB NPC treated by IMRT were included. For all patients, treatment-planning computed tomography was done twice before and during IMRT to a total dose of 60-70 Gy/28-35 fractions (median 68 Gy). Chemotherapy (cisplatin 80 mg/m(2)/3 weeks x 1-3 courses) was given concurrently with IMRT for 31 patients.The 3- and 5-year overall survival rates for the 31 patients treated with concurrent chemotherapy were 88% and 83%, respectively. The 3- and 5-year loco-regional control rates for the 31 patients were 93% and 87%, respectively. Planning target volume delineation for the primary site or involved nodes was insufficient for three early cases, resulting in marginal recurrence in the three patients (9%). Except for one patient with early death, xerostomia scores at 1-2 years were: Grade 0, 11; Grade 1, 17; Grade 2, 5; Grade 3, 1.Excellent overall survival and loco-regional control rates were obtained by a two-step IMRT method with concurrent chemotherapy for NPC, although marginal recurrence was noted in some early cases.