Endoscope-guided interstitial intensity-modulated brachytherapy and intracavitary brachytherapy as boost radiation for primary early T stage nasopharyngeal carcinoma.
Endoscope-guided interstitial intensity-modulated brachytherapy and intracavitary brachytherapy as boost radiation for primary early T stage nasopharyngeal carcinoma.
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内窥镜引导间质调强近距离放射治疗和腔内近距离放射治疗作为原发性早期 T 期鼻咽癌的增强放射治疗
DOI：
10.1371/journal.pone.0090048
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Chen MY
中科院分区：
文献类型：
--
作者：
Wan XB;Jiang R;Xie FY;Qi ZY;Li AJ;Ye WJ;Hua YJ;Zhu YL;Zou X;Guo L;Mai HQ;Guo X;Hong MH;Chen MY
背景腔内近距离放射治疗（ICBT）是鼻咽癌（NPC）初次外束放射治疗（ERT）后浅表残留的增强放疗。在这里，我们评估了内窥镜引导下间质调强近距离放射治疗（IMBT）对深层残余鼻咽癌的效果。方法/主要发现回顾性分析了2005-2009年接受近距离增强放射治疗的213例鼻咽癌残余患者。其中171例鼻咽癌浅表残留（鼻咽上皮以下≤1cm）患者行ICBT增强放疗，42例鼻咽癌深部残留（鼻咽上皮以下≤1cm）患者行间质性IMBT增强放疗。我们发现IMBT增压亚组的T2b （81.0% VS 34.5%， P<0.001）和II期（90.5% VS 61.4%, P = 0.001）比例高于ICBT增压亚组。两组鼻咽部外束放疗剂量（63.0±3.8 Gy VS 62.6±4.3 Gy, P = 0.67）和区域淋巴结外束放疗剂量（55.8±5.0 Gy VS 57.5±5.7 Gy, P = 0.11）具有可比性。在近距离治疗中，IMBT亚组的增强辐射剂量低于ICBT亚组（11.0±2.9 Gy VS 14.8±3.2 Gy， P<0.01）。虽然IMBT组肿瘤残留更深，增强放疗剂量更低，但两组的5年精算总生存率（IMBT VS ICBT组：96.8% VS 93.6%, P = 0.87）、无进展生存率（92.4% VS 86.5%, P = 0.41）和远端无转移生存率（94.9% VS 92.7%, P = 0.64）相似。此外，IMBT增强辐射亚组的局部控制率（97.4% VS 94.4%, P = 0.57）和区域控制率（95.0% VS 97.2%, P = 0.34）与ICBT亚组相似。急性和晚期毒性发生率在两个亚组之间具有可比性。结论/意义IMBT增强放疗是深部鼻咽癌残留治疗的理想选择。
Background Intracavitary brachytherapy (ICBT) is usually applied as boost radiotherapy for superficial residual of nasopharyngeal carcinoma (NPC) after primary extern-beam radiptherapy (ERT). Here, we evaluated the outcome of endoscope-guided interstitial intensity-modulated brachytherapy (IMBT) boost radiation for deep-seated residual NPC. Methodology/Principal Findings Two hundred and thirteen patients with residual NPC who were salvaged with brachytherapy boost radiation during 2005–2009 were analyzed retrospectively. Among these patients, 171 patients had superficial residual NPC (≤1 cm below the nasopharyngeal epithelium) were treated with ICBT boost radiation, and interstitial IMBT boost radiation was delivered to 42 patients with deep-seated residual NPC (>1 cm below the nasopharyngeal epithelium). We found that IMBT boost subgroup had a higher ratio of T2b (81.0% VS 34.5%, P<0.001) and stage II (90.5% VS 61.4%, P = 0.001) than that of ICBT boost subgroup. The dosage of external-beam radiotherapy in the nasopharyngeal (63.0±3.8 VS 62.6±4.3 Gray (Gy), P = 0.67) and regional lymph nodes (55.8±5.0 VS 57.5±5.7 Gy, P = 0.11) was comparable in both groups. For brachytherapy, IMBT subgroup had a lower boost radiation dosage than ICBT subgroup (11.0±2.9 VS 14.8±3.2 Gy, P<0.01). Though the IMBT group had deeper residual tumors and received lower boost radiation dosages, both subgroups had the similar 5-year actuarial overall survival rate (IMBT VS ICBT group: 96.8% VS 93.6%, P = 0.87), progression-free survival rate (92.4% VS 86.5%, P = 0.41) and distant metastasis-free survival rate (94.9% VS 92.7%, P = 0.64). Moreover, IMBT boost radiation subgroup had a similar local (97.4% VS 94.4%, P = 0.57) and regional (95.0% VS 97.2%, P = 0.34) control to ICBT subgroup. The acute and late toxicities rates were comparable between the both subgroups. Conclusions/Significance IMBT boost radiation may be a promising therapeutic selection for deep-seated residual NPC.
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DOI：
10.1097/00000421-199102000-00002
发表时间：
1991-02-01
影响因子：
2.6
作者：
WANG, CC
通讯作者：
WANG, CC
DOI：
10.1016/s0360-3016(99)00326-0
发表时间：
2000-01-15
影响因子：
7
作者：
Teo, PML;Leung, SF;Zee, B
通讯作者：
Zee, B
影响因子：
3.8
作者：
Palmer, A. L.;Di Pietro, P.;Nisbet, A.
通讯作者：
Nisbet, A.
DOI：
10.1016/s0360-3016(00)00702-1
发表时间：
2000-10-01
影响因子：
7
作者：
Sultanem, K;Shu, HK;Fu, KK
通讯作者：
Fu, KK
DOI：
10.1016/j.ijrobp.2009.08.072
发表时间：
2010-11-01
影响因子：
7
作者：
Schinagl, Dominic A. X.;Marres, Henri A. M.;Kaanders, Johannes H. A. M.
通讯作者：
Kaanders, Johannes H. A. M.