用强度调制辐射处理的847例鼻咽癌病例的效应分析：经验和建议
Effect analysis of 847 nasopharyngeal carcinoma cases treated with intensity modulated radiation: Experience and suggestions
影响因子:3.90000
分区:医学2区 / 牙科与口腔外科2区 肿瘤学3区
发表日期:2024 Nov
作者:
Wen-Jing Yin, Wu Mao, Fang Yang, Meng-Yao Wang, Jin-Quan Liu, Dong-Ping Chen, Li-Ping Zhou, Si-Da Chen, Xi-Zhen Jiang, Yu-Meng Ou, Zheng Wu, Bin Qi
摘要
为了确定在2012年至2012年间，IMRT在2012年和2016年对847例NPC治疗的847例NPC治疗的847例患者的DATA中，在强度调节放疗（IMRT）ERA中，非转移性鼻咽癌（NPC）的失败模式和预后因素。分析了生存预后，失败模式和预后因素。局部5年的无局部无复发生存，无淋巴结复发生存，无转移的生存，无疾病的生存率和整体存活率分别为94.3％，95.3％，84.8％，76.5％和85.7％。局部主要复发位点是鼻咽（91.5％，43/47）和颅底（68.1％，32/47）； 39名患者患有场地失败，4例出现了边际失败，四名患者发生了场外故障。 IIB级（62.2％，23/37）是最常见的区域复发部位，其次是IIA（35.1％，13/37）和咽后脑区域（32.4％，12/37）； 35例仅发生场地故障，一个案件仅出现场外故障，而一个案件均出现了场外和外场失败。 TNM阶段是预测预测的最重要因素。 402（47.5％）患者患有3级或4级的急性不良事件；白细胞减少症（31.5％）和粘膜炎（26.7％）分别是最常见的血液学和非血液学事件。晚期并发症是轻微或中等的损害；静态（647/847，76.4％）和听力障碍（422/847，49.8％）仍然是最麻烦的。接受IMRT治疗的NPC患者获得了令人满意的生存结果。关键故障模式是遥远的转移。局部区域故障的主要模式是场地故障。应研究使用远处转移和优化放射治疗靶标的高风险患者。
Abstract
To identify the failure patterns and prognostic factors of nonmetastatic nasopharyngeal carcinoma (NPC) in the intensity-modulated radiotherapy (IMRT) era.Data on 847 patients with newly diagnosed, non-disseminated NPC treated by IMRT between 2012 and 2016 were retrospectively reviewed. Survival outcome, failure patterns and prognosis factors were analyzed.The 5-year local relapse-free survival, nodal relapse-free survival, distant metastasis-free survival, disease-free survival, and overall survival rates were 94.3%, 95.3%, 84.8%, 76.5% and 85.7%, respectively. The major local recurrence sites were the nasopharynx (91.5%, 43/47) and skull base (68.1%, 32/47); 39 patients had in-field failures, four had marginal failures, and four had out-field failures. Level IIb (62.2%, 23/37) was the most frequent regional recurrence site, followed by IIa (35.1%, 13/37) and retropharyngeal region (32.4%, 12/37); 35 cases had in-field failure alone, one had out-field failure alone, and one had both in- and out-field failure. TNM stage was the most significant factor for prognosis prediction. 402 (47.5%) patients had acute adverse events of grade 3 or 4; leukopenia (31.5%) and mucositis (26.7%) was the most common hematological and non-hematological event, respectively. Late complications were slight or moderate damages; xerostomia (647/847, 76.4%) and hearing impairment (422/847, 49.8%) remained the most troublesome.NPC patients treated with IMRT obtained satisfactory survival outcomes. The key failure pattern was distant metastasis. The main pattern of local-regional failure was in-field failure. Screening high risk patients with distant metastases and optimizing radiotherapy targets should be studied.