鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应对比分析

doi:10.11904/j.issn.1002-3070.2020.05.010

摘要/Abstract

摘要： 目的对比分析鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应。方法回顾性分析自2007年1月—2008年12月于我院接受同步放化疗后的90例鼻咽癌患者,其中同步推量组45例,常规分割后缩野组45例。对比分析两组患者的5年总生存率(Overall survival,OS)、无进展生存率(Progression free survival,PFS)、无局部区域复发生存率(Loco-regional recurrence-free survival,LRFS)以及毒性反应。结果同步推量组5年OS、PFS、LRFS分别为84.4%、75.6%、88.9%,常规分割后缩野组5年OS、PFS、LRFS分别为82.2%、71.1%、86.7%,两组OS、PFS、LRFS差异无统计学意义。常规分割后缩野组脑干、脊髓、腮腺放疗反应要轻于同步推量组。结论在调强放疗时代,应用同步推量同步放化疗和常规分割后缩野同步放化疗两种方式在预后方面无统计学差异,而常规分割后缩野组放疗毒性较轻。

关键词: 鼻咽癌, 同步推量放射治疗, 常规分割后缩野放射治疗, 同步放化疗, 毒性反应

Abstract: Objective The efficacy and toxicity of concurrent chemoradiotherapy(CRT)with concurrent bolus and CRT with conventional fractionation and shrinking field for nasopharyngeal carcinoma(NPC)were compared.Methods A retrospective analysis was performed in 90 patients with NPC who received radiotherapy and chemotherapy in our hospital from January 2007 to December 2008.The 5-year overall survival(OS),progression free survival(PFS),local recurrence free survival(LRFS)and toxicity were compared between the two groups.Results The 5-year OS,PFS and LRFS of CRT with concurrent bolus group were 84.4%,75.6% and 88.9%,respectively,while those of CRT with conventional fractionated field group were 82.2%,71.1% and 86.7%,respectively.There were no differences of OS,PFS and LRFS between the CRT with concurrent bolus and conventional fractionated field groups.The radiation response of brainstem,spinal cord and parotid gland in the conventional fractionated field CRT group was lighter than that in the CRT with concurrent bolus group.Conclusion There is no significant difference in the prognosis between the CRT with concurrent bolus and conventional fractionated field groups in the ear of intensity modulated radiation therapy,but the toxicity of CRT with conventional fractionated field group is lighter.

Key words: Nasopharyngeal carcinoma, Concurrent bolus radiotherapy, Conventional fractionated retroflex field radiotherapy, Concurrent chemoradiotherapy, Toxicity

中图分类号:

R739.6

卢江岳, 张建鑫, 葛晓峰. 鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应对比分析[J]. 实用肿瘤学杂志, 2020, 34(5): 440-445.

LU Jiangyue, ZHANG Jianxin, GE Xiaofeng. A comparative study of the efficacy and toxicity of concurrent bolus chemoradiotherapy and conventional fractionated retroflex field concurrent chemoradiotherapy for nasopharyngeal carcinoma[J]. Journal of Practical Oncology, 2020, 34(5): 440-445.

0
/ / 推荐

导出引用管理器 EndNote|Reference Manager|ProCite|BibTeX|RefWorks

链接本文: http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/10.11904/j.issn.1002-3070.2020.05.010

http://journal09.magtechjournal.com/Jwk3_syzlxzz/CN/Y2020/V34/I5/440

参考文献

1 Lee AW,Lin JC,Ng WT.Current management of nasopharyngeal cancer[J].Semin Radiat Oncol,2016,22(3):233-244.
2 Young YH.Irradiated ears in nasopharyngeal carcinoma survivors:a review[J].Int J Laryngoscope,2019,129(3):637-642.
3 Su B,Xu T,Bruce JP,et al.hsamiR24 suppresses metasis in nasopharyngeal carcinoma by regulating the cMyc/epithelial meessenchymal transition axis[J].Int J Oncol Rep,2018,40(5):2536-2546.
4 Moumad K,Khaali W,Benider A,et al.Joint effect of smoking and NQO1 C609T polymorphism on undifferentiated nasopharyngeal carcinoma risk in a North African population[J].In J Mol Genet Genomic Med,2018,6(6):933-940.
5 Pan XB,Chen KH,Huang ST,et al.Comparison of the efficacy between intensity-modulated radiotherapy and two-dimensional cobentional radiotherapy in stage II nassopharyngeal carcinoma[J].In J Oncotarget,2017,8(44):78096-78104.
6 Woo SY,Sanders M,Grant W.Does the "Peacock"really have anything to do withradiotherapy[J].Int J Radiat Oncol Biol Phys,1994,29:213-214.
7 Hunt MA,Zelefsky MJ,Wolden S.Treatment planning and delivery of intensity-modulated radiaton therapy for primary nasopharynx cancer[J].Int J Badiat Oneol Biol Phys,2018,49:623-632.
8 Yi JL,Huang XO,Cao L.Nasopharyngeal carcinoma treated by radical radiotherapy alone:ten-year experience of a single institution[J].Int J Radiat Oncol Biol Phys,2018,65:161-168.
9 Tuan JK,Ha TC,Ong WS,et al.Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma[J].Radiother Oncol,2017,104(3):305-311.
10 Wu SX,Chua DTT,Deng ML.Outcome of fractionated stereotactic radiotherapy for 90 patients with locally persistent and recurrent nasopharyngeal carcinoma[J].Int J Radiat Oncol Biol Phys,2017,69:761-769.
11 Lee N,Xia P,Quivey JM.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:anupdate of the UCSF experience[J].Int J Radiat Oncol Biol Phys,2017,53(1):12.
12 Butler EB,Teh BS,Grant WH.Smart(simultaneous modulated accerlerated radiation therapy)boost:a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy[J].Int J Radiat Oncol,2015,53(1):12-22.
13 Kam MK,Teo PM,Chau RM.Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:the Hong Kong experience[J].Int J Radia Oncol Biol Phys,2017,53(1):12-22.
14 张振坤,李桂生.鼻咽癌调强放疗与常规放疗的疗效及副反应对比研究[J].中华医院感染学杂志,2011,21(14):2942-2945.
15 林坤花,黄建丽,谢源福.同步放化疗治疗局部晚期鼻咽癌并医院感染的临床分析[J].中华医院感染学杂志,2011,21(14):2942-2945.
16 Chua GWY,Chua ET.Long-term disease-free survival of a patient with oligometastatic nasopharyngeal caicinoma treated with radiotherapy alone[J].Int J Case Rep Oncol,2018,11(2):392-398.
17 冯梅,范子煊,黎杰.582例鼻咽癌调强放疗5年远期疗效及预后分析[J].中华放射肿瘤学杂志,2011,20(5):369-373.
18 陈忠,章恒.三维适形调强放射疗法治疗鼻咽癌的急性反应和晚期损伤[J].中国医药,2014,9(3):423-426.
19 Al-Sarraf M,LeBlanc M,Giri PG,et al.Superiority of five year survival with chemo-radiotherapy(CT-RT)vs.radiotherapy in patients(Pts)with locally advanced nasopharyngeal cancer(NPC)[J].Proc Am Soc Clin Oncol,2018,20:227.
20 Chen C,Fei Z,Chen L.Will weight loss cause significant dosimetric changes of target volumes and organs at risk in nasopharyngeal carcinoma treated intensity-modulated radiation therapy[J].Med Dosin,2017,39(1):34-37.
21 Gamba P,Rota L,Abeni C,et al.Inregrated diagnostic model that incorporates Epstein-Barr virus DNA,imaging,and nasal endoscopy to stratify primary tumor and lymph nodes in a patient with N1 nasopharyngeal caicinoma:multidisciplinary managent[J].Int J Case Rep Oncol,2018,11(2):289-297.
22 Wang C,Liu L,Lai S,et al.Diagnostic value of diffusion-weighted magnetic reasonance imaging for local and skull base recurrence of nasopharyngeal caicinoma after radiotheray[J].Int J Medicine(Baltimore),2018,97(34):929.

[1]	谢艺才, 高健全. 动态增强MRI成像在鼻咽癌诊疗中的应用价值[J]. 实用肿瘤学杂志, 2020, 34(3): 258-261.
[2]	王棹, 冯越, 邢丽楠, 张云艳. PLR与恶性肿瘤同步放化疗预后的研究进展[J]. 实用肿瘤学杂志, 2020, 34(3): 271-275.
[3]	阮鹏, 谭爱丽. 血清中microRNA-127对鼻咽癌患者化疗抗性的预测价值[J]. 实用肿瘤学杂志, 2019, 33(6): 508-512.
[4]	刘耿淳, 申良方. 血清长链非编码RNA MALAT1和AFAP1-AS1与鼻咽癌临床病理特征和预后的关系[J]. 实用肿瘤学杂志, 2019, 33(6): 513-518.
[5]	陈光浩, 方靖萱, 彭素娟, 严炜薇, 王福海, 陈承哲, 陈泗川, 潘建基, 邱素芳. PNCK对鼻咽癌细胞增殖和凋亡作用的研究[J]. 实用肿瘤学杂志, 2019, 33(5): 397-401.
[6]	冯越,邢丽楠,王棹,张云艳. NLR与肿瘤同步放化疗预后的相关性研究[J]. 实用肿瘤学杂志, 2019, 33(3): 284-288.
[7]	张攀, 张迪综述, 戴晓波审校. 复发鼻咽癌再程放射治疗的研究进展[J]. 实用肿瘤学杂志, 2019, 33(1): 92-96.
[8]	李丹，王勇. 微创外科治疗联合药物对局限性鼻咽癌微小浸润灶的近远期疗效分析[J]. 实用肿瘤学杂志, 2017, 31(3): 234-237.
[9]	刘伟锋, 徐凡, 吴梅. DCE-MRI 4D-Tissue技术定量参数评估宫颈癌放化疗疗效的预测价值[J]. 实用肿瘤学杂志, 2016, 30(3): 225-228.
[10]	刘纤, 任刚, 李莉琴, 朱夫海, 夏廷毅. 胰腺癌螺旋断层调强放疗高剂量少分次模式的胃肠毒副反应相关因素分析[J]. 实用肿瘤学杂志, 2015, 29(6): 481-486.
[11]	李书桢, 杨云利. 鼻咽癌侵犯鼻窦的研究进展[J]. 实用肿瘤学杂志, 2015, 29(6): 573-576.
[12]	李汝懿综述, 陆建波审校. 基因表达谱在肿瘤病理诊断与鉴别诊断中的意义[J]. 实用肿瘤学杂志, 2015, 29(3): 275-278.
[13]	燕小飞(综述),韩波(审校). 局部晚期鼻咽癌的治疗现状及展望[J]. 实用肿瘤学杂志, 2015, 29(2): 149-152.
[14]	刘立华,朱广迎,石安辉,耿建昊. 局部晚期非鳞非小细胞肺癌同步放化疗两种方案比较研究[J]. 实用肿瘤学杂志, 2014, 28(5): 420-425.
[15]	陈荣梅综述,葛晓峰审校. 鼻咽癌组织中HIF-1α、GLUT-1的表达与放疗敏感性关系的研究进展[J]. 实用肿瘤学杂志, 2013, 27(5): 452-456.