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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Sequential external beam radiotherapy and high-dose-rate intracavitary brachytherapy in T1 and T2 nasopharyngeal carcinoma: an evaluation of long-term outcome.
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Sequential external beam radiotherapy and high-dose-rate intracavitary brachytherapy in T1 and T2 nasopharyngeal carcinoma: an evaluation of long-term outcome.

机译：T1和T2鼻咽癌序贯外照射和高剂量腔内近距离放射治疗：长期预后评估。

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OBJECTIVES/HYPOTHESIS: The standard treatment for nonmetastatic nasopharyngeal carcinoma (NPC) is external beam radiotherapy (EBRT), with or without chemotherapy. Because local control in NPC is an independent prognostic factor for distant metastases and survival, various dose-escalation strategies have been used to reduce recurrences at the primary site. The objective of this report was to evaluate the outcome of adjuvant high-dose-rate intracavitary brachytherapy (HDRIB) in patients with T1 and T2 NPC. STUDY DESIGN AND METHODS: Thirty-three consecutive patients with T1 and T2 NPC were treated prospectively according to a standardized institutional protocol between March 1999 and July 2001. Seventeen patients with stage I/II disease were treated with EBRT to 66 Gy followed by HDRIB (10 Gy in 2 weekly 5 Gy fractions). The remaining 16 patients with Stage III to IVb disease received chemotherapy in addition to radiation. All patients were assessed for treatment response, local control, survival, and toxicity. RESULTS: Median follow-up for all surviving patients was 67 (range 52-76) months. Local failure occurred in two patients; both subsequently underwent successful salvage treatments. Three patients died of metastatic disease, whereas two died of unrelated causes. Five year local control, overall survival, and disease-free survival rates were 93.8%, 83.9% and 78.4%, respectively. All patients experienced acute or late radiotherapy-related sequelae. However, no grade 4/5 toxicities were reported. Specifically, toxicities that could be attributed to brachytherapy were not seen, except for in one patient who developed severe choanal stenosis. CONCLUSIONS: EBRT supplemented by HDRIB produced superior local control rates for T1 and T2 NPC at 5 years of follow-up, with acceptable rates of acute and late toxicities.
机译：目的/假设：非转移性鼻咽癌（NPC）的标准治疗方法是采用或不采用化学疗法的体外束放射疗法（EBRT）。由于NPC的局部控制是远处转移和生存的独立预后因素，因此已采用各种剂量递增策略来减少原发部位的复发。该报告的目的是评估T1和T2 NPC患者的辅助高剂量率腔内近距离放射治疗（HDRIB）的结果。研究设计与方法：1999年3月至2001年7月，按照标准化的机构治疗方案对33例T1和T2鼻咽癌连续患者进行了前瞻性治疗。对I / II期疾病的17例患者进行了EBRT至66 Gy治疗，随后进行HDRIB治疗（ 10 Gy（每周2次，每次5 Gy馏分）。其余16例III至IVb期患者除接受放射治疗外，还接受了化学疗法。对所有患者进行治疗反应，局部控制，生存和毒性评估。结果：所有幸存患者的中位随访时间为67（52-76）个月。两名患者发生局部衰竭。两人随后都进行了成功的抢救治疗。 3例患者死于转移性疾病，而2例患者死于无关原因。五年本地控制率，总生存率和无病生存率分别为93.8％，83.9％和78.4％。所有患者均经历了急性或晚期放疗相关的后遗症。然而，没有报道4/5级毒性。具体而言，除了一名严重的狭窄性胆管狭窄患者外，未发现可归因于近距离放射治疗的毒性。结论：EBRT补充HDRIB在5年的随访中产生了较高的T1和T2 NPC局部控制率，可接受的急性和晚期毒性率。

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