| Jiang Hao,Wang Gengming,Song Hongwei,et al.Comparison of efficacy of intensity-modulated and conventional radiotherapy for nasopharyngeal carcinoma involving cervical vertebrae：analysis of 53 cases[J].Chinese Journal of Radiological Medicine and Protection,2014,34(3):211-214 |
| Comparison of efficacy of intensity-modulated and conventional radiotherapy for nasopharyngeal carcinoma involving cervical vertebrae：analysis of 53 cases |
| Received:July 09, 2013 |
| DOI：10.3760/cma.j.issn.0254-5098.2014.03.013 |
| KeyWords:Nasopharyngeal carcinoma Cervical vertebra involvement Intensity-modulated radiotherapy Conventional radiotherapy Prognosis |
| FundProject:安徽省“十二五”临床医学重点专科建设基金（01Z33）；安徽省高校省级自然科学研究项目基金（KJ2007B199） |
| Author Name | Affiliation | | Jiang Hao | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Wang Gengming | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Song Hongwei | 233004 蚌埠医学院第一附属医院放射科 | | Xu Hongbo | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Zhang Yajun | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Zhou Yufu | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Cai Hanfei | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China | | Duan Shimiao | Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China |
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| Abstract:: |
| Objective To compare the efficacy and side-effects of intensity-modulated radiotherapy (IMRT) and conventional radiotherapy in treatment of nasopharyngeal carcinoma (NPC) involving cervical vertebrae. Methods Twenty-four patients of NPC with cervical vertebra involvement underwent IMRT with the dose to tumor target of 72-74 Gy divided into 33 fractions (IMRT group), and 29 patients underwent conventional radiotherapy with the total dose to tumor target of 68-74 Gy/34-37 fractions (2D-CRT group). All the 53 cases accepted platinum-based concurrent chemotherapy of cisplatin plus fluorouracil and 4-6 cycles of adjuvant chemotherapy after the radiotherapy. Follow-up was conducted for 6 months to more than 7 years. Results The 3-and 5-year overall survival (OS) rates of the IMRT group were 87.7% and 65.5% respectively, both significantly higher than those of the 2D-CRT group (45.5% and 9.1% respectively, χ2=6.89, P<0.05), and the 3-and 5-year local progression-free survival (LPFS) rates of the IMRT group were 87.4% and 49.4% respectively, both significantly higher than those of the 2D-CRT group (69.9% and 9.4% respectively, χ2=13.26,P<0.05), and there were no significant statistical differences in the 3-, and 5-year distant metastasis-free survival (DMFS) rates (94.4% vs 40.8% and 79.8% vs 30.4% respectively, χ2=2.29,P>0.05) between two groups. Analysis showed N stage (χ2=8.53, P<0.05) and radiotherapy protocol (χ2=8.02, P<0.05) as the independent prognostic factors for OS and LPFS. The incidence of grade 2 and 3 xerostomia of the IMRT group was 29.17%, significantly lower than that of the 2D-CRT group (65.52%, χ2=7.11, P<0.05). Whereas, there were no significant statistical differences between these 2 groups in the incidence rates of acute irradiation mucositis and bone marrow suppression. Conclusions IMRT improves the local progression-free survival and overall survival and reduces the incidence of grade 2 and 3 radiation-induced xerostomia in local advanced NPC with cervical vertebra involvement more effectively than conventional radiotherapy. However, it fails to reduce the incidence of distant metastasis. |
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