Quality of life and survival outcome for patients with nasopharyngeal carcinoma receiving three-dimensional conformal radiotherapy vs. intensity-modulated radiotherapy - A longitudinal study
Quality of life and survival outcome for patients with nasopharyngeal carcinoma receiving three-dimensional conformal radiotherapy vs. intensity-modulated radiotherapy - A longitudinal study
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DOI：
10.1016/j.ijrobp.2007.12.054
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发表时间：
2008-10-01
影响因子：
7
通讯作者：
Huang, Hsuan-Ying
中科院分区：
文献类型：
--
作者：
Fang, Fu-Min;Chien, Chih-Yen;Huang, Hsuan-Ying
目的：探讨三维适形放疗（3D-CRT）与调强放疗（IMRT）对鼻咽癌（NPC）患者生活质量（QoL）和生存结局的影响。203例新发鼻咽癌患者，方法：对2002年3月至2004年7月间接受3D-CRT（n = 93）和IMRT（n = 110）治疗的110例乳腺癌患者进行回顾性分析。按美国癌症联合委员会1997年临床分期标准，Ⅰ期15例（7.4%），Ⅱ期78例（38.4%），Ⅲ期10例（1.4%）。III：74（36.5%），IV：36（17.7%）。通过欧洲癌症研究与治疗组织（EORTC）QLQ-C30和EORTC QLQ-H&N35问卷在5个时间点纵向评估QoL：RT前、RT期间（36戈伊）、RT后3个月、12个月和24个月。3D-CRT组的3年局部区域控制率、无转移生存率和总生存率分别为84.8%、76.7%和81.7%，而3D-CRT组分别为84.2%、82.6%和82.6%。IMRT组为85.4%（p值> 0.05）。RT期间观察到大多数QoL量表最大恶化的总体趋势，随后逐渐恢复。两组在各时间点的大部分量表评分均无显著性差异。例外的是，接受IMRT治疗的患者在RT后3个月的时间点上，在全球生活质量、疲劳、味觉/嗅觉、口干和不适感方面均有统计学和临床显著改善。结论：IMRT治疗NPC患者的潜在优势可能发生在急性毒性恢复期的生活质量结局中。Q 2008 Elsevier Inc.
Purpose: To investigate the changes of quality of life (QoL) and survival outcomes for patients with nasopharyngeal carcinoma (NPC) treated by three-dimensional conformal radiotherapy (3D-CRT) vs. intensity-modulated radiotherapy (IMRT).Methods and Materials: Two hundred and three newly diagnosed NPC patients, who were curatively treated by 3D-CRT (n = 93) or IMRT (n = 110) between March 2002 and July 2004, were analyzed. The distributions of clinical stage according to American Joint Committee on Cancer 1997 were I: 15 (7.4%), II: 78 (38.4%), ?III: 74 (36.5%), and IV: 36 (17.7%). QoL was longitudinally assessed by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35 questionnaires at the five time points: before RT, during RT (36 Gy), and 3 months, 12 months, and 24 months after RT.Results: The 3-year locoregional control, metastasis-free survival, and overall survival rates were 84.8%, 76.7%, and 81.7% for the 3D-CRT group, respectively, compared with 84.2%, 82.6%, and 85.4% for the IMRT group (p value > 0.05). A general trend of maximal deterioration in most QoL scales was observed during RT, followed by a gradual recovery thereafter. There was no significant difference in most scales between the two groups at each time point. The exception was that patients treated by IMRT had a both statistically and clinically significant improvement in global QoL, fatigue, taste/smell, dry mouth, and feeling ill at the time point of 3 months after RT.Conclusions: The potential advantage of IMRT over 3D-CRT in treating NPC patients might occur in QoL outcome during the recovery phase of acute toxicity. Q 2008 Elsevier Inc.