https://scholars.lib.ntu.edu.tw/handle/123456789/514684
標題: | Intensity-modulated radiation therapy for T4 nasopharyngeal carcinoma: Treatment results and locoregional recurrence | 作者: | JENNY LING-YU CHEN YU-SEN HUANG SUNG-HSIN KUO YA-FANG CHEN RUEY-LONG HONG JENG-YUH KO PEI-JEN LOU CHIAO-LING TSAI WAN-YU CHEN CHUN-WEI WANG |
公開日期: | 2013 | 卷: | 189 | 期: | 12 | 起(迄)頁: | 1001-1008 | 來源出版物: | Strahlentherapie und Onkologie | 摘要: | Purpose: The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods and materials: Between 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, 97 % of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months. Results: The rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were 81.2, 72.2, 61.9, and 78.1 %, respectively. A total of 27 patients had locoregional recurrence: 85.2 % in-field failures, 11.1 % marginal failures, and 3.7 % out-of-field failures. Fourteen patients with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or re-irradiation, and the 5-year OS rate tended to be better (61.9 %) compared to those receiving conservative treatment (32.0 %, p = 0.051). In patients treated with 1 course of radiotherapy, grade ? 3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6 % of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation. Conclusion: IMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after definitive radiotherapy, aggressive local treatment may be considered for a better outcome. ? 2013 Springer Heidelberg Berlin. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/514684 | ISSN: | 0179-7158 | DOI: | 10.1007/s00066-013-0429-8 | SDG/關鍵字: | cisplatin; epirubicin; fluorouracil; folinic acid; mitomycin; antineoplastic agent; cisplatin; adolescent; adult; aged; artery embolism; article; bone necrosis; brain necrosis; cancer combination chemotherapy; cancer control; cancer radiotherapy; cancer recurrence; cancer surgery; cancer survival; carotid artery stenting; chemoradiotherapy; child; conservative treatment; cranial neuropathy; distant metastasis free survival; ear nose throat surgery; endoscopic surgery; epistaxis; feasibility study; female; fibrosis; follow up; human; hyperbaric oxygen; intensity modulated radiation therapy; internal carotid artery occlusion; major clinical study; male; middle aged; mucosa inflammation; multimodality cancer therapy; multiple cycle treatment; nasopharyngectomy; nasopharynx carcinoma; neck dissection; neck fibrosis; ototoxicity; outcome assessment; overall survival; potassium titanyl phosphate laser; progression free survival; radiation dermatitis; radiation dose fractionation; radiation injury; radiation necrosis; radiotherapy equipment; radiotherapy planning system; retreatment; salvage therapy; school child; soft tissue injury; temporal lobe necrosis; tracheostomy; transcatheter arterial embolism; treatment failure; very elderly; xerostomia; young adult; adjuvant chemoradiotherapy; clinical trial; computer assisted radiotherapy; disease free survival; epidemiology; mortality; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; prevalence; risk assessment; survival; survival rate; Taiwan; treatment outcome; Adolescent; Adult; Aged; Antineoplastic Agents; Chemoradiotherapy, Adjuvant; Child; Cisplatin; Disease-Free Survival; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Prevalence; Radiotherapy, Conformal; Risk Assessment; Survival Analysis; Survival Rate; Taiwan; Treatment Outcome; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。