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首页> 外文期刊>癌症（英文版） >Effects of dosimetric inadequacy on local control and toxicities in the patients with T4 nasopharyngeal carcinoma extending into the intracranial space and treated with intensity-modulated radiotherapy plus chemotherapy
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Effects of dosimetric inadequacy on local control and toxicities in the patients with T4 nasopharyngeal carcinoma extending into the intracranial space and treated with intensity-modulated radiotherapy plus chemotherapy

机译：剂量不足对T4鼻咽癌扩展至颅内间隙并用调强放疗联合化疗的患者的局部控制和毒性的影响

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摘要

Background:To protect neurological tissues,underdosing occurs in most cases ofT4 nasopharyngeal carcinoma (NPC) with intracranial extension.In this study,we aimed to evaluate the effect of dosimetric inadequacy on local control and late neurological toxicities for patients treated with intensity-modulated radiotherapy (IMRT) plus chemotherapy.Methods:We prospectively enrolled patients who had non-metastatic T4 NPC with intracranial extension treated between January 2009 and November 2013.The prescribed dose was 66.0-70.4 Gy to the primary planning target volume (primary gross tumor volume [GTVp;i.e.,the nasopharyngeal tumor] + 5.0 mm).Dose-volume histogram parameters were calculated,including minimum point dose (Dmin) and dose to 95％ of the target volume (D9s).All patients received chemotherapy with the cisplatin,5-fluorouracil,and docetaxel regimen.Survivals were estimated using the Kaplan-Meier method and compared using the log-rank test.Results:In total,41 patients were enrolled.The local partial response rate was 87.8％ after induction chemotherapy.With a median follow-up of 51 months,7 patients experienced failure in the nasopharynx;the 3-year local failure-free survival and overall survival rates of the 41 patients were 87.4％ and 90.2％,respectively.The actual mean Dmin to the GTVp was 55.2 Gy (range 48.3-67.3 Gy),and D9s was 61.6 Gy (range 52.6-69.0 Gy).All doses received by neurological organs remained well within their dose constraints.No patients developed temporal lobe necrosis or other neurological dysfunctions.Conclusions:With relative underdosed IMRT plus effective chemotherapy,the patients achieved satisfactory local control with few late toxicities of the central nervous system.Determining the acceptable extent of dosimetric inadequacy requires further exploration.
机译：背景：为保护神经系统，在大多数颅内扩张的T4鼻咽癌（NPC）中发生剂量不足。方法：我们对2009年1月至2013年11月间接受非转移性T4 NPC颅内延伸治疗的患者进行了前瞻性研究。处方剂量为主要规划目标体积（原发肿瘤总体积[66.0-70.4 Gy GTVp;即鼻咽肿瘤] + 5.0 mm）。计算剂量体积直方图参数，包括最小点剂量（Dmin）和达到目标体积的95％的剂量（D9s）。所有患者均接受了顺铂化疗，5 -氟尿嘧啶和多西他赛方案。生存率采用Kaplan-Meier方法评估，并采用log-rank检验进行比较。结果：总共有41例患者入选。诱导化疗后局部局部缓解率为87.8％。中位随访51个月，有7例鼻咽衰竭; 41例3年局部无衰竭生存率和总生存率为87.4％。分别为90.2％.GTVp的实际平均Dmin为55.2 Gy（范围为48.3-67.3 Gy），而D9s为61.6 Gy（范围为52.6-69.0 Gy）。神经​​器官接受的所有剂量均在其剂量限制内。结论：采用相对剂量不足的IMRT加上有效的化学疗法，患者达到了满意的局部控制，对中枢神经系统的后期毒性很小。确定可接受的剂量学上不足的程度需要进一步探索。

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  • 来源
    《癌症（英文版）》 |2017年第009期|398-406|共9页
  • 作者

    Fen Xue; Chao-Su Hu; Xia-Yun He;

  • 作者单位

    Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R.China;

    Department of Oncology, Shanghai Medical College, Shanghai 200032, P.R.China;

    Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R.China;

    Department of Oncology, Shanghai Medical College, Shanghai 200032, P.R.China;

    Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R.China;

    Department of Oncology, Shanghai Medical College, Shanghai 200032, P.R.China;

  • 收录信息 北京大学中文核心期刊目录(北大核心);中国科学引文数据库(CSCD);中国科技论文与引文数据库(CSTPCD);
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