Recurrent Patterns in Patients With Nasopharyngeal Caricinoma and Risks Leading to Inaccurate Delineation in Marginal Failure in the Era of Intensity-Modulated Radiotherapy.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-11-05 DOI:10.1002/hed.27987

Shu Zhang, Ni Zeng, Jiangping Yang, Jiaqi Han, Jinlan He, Baofeng Duan, Xiaoqiang Chen, Xiaofang Gou, Fubin Zhu, Huizhen Liu, Ming Zeng, Di Yan, Nianyong Chen

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Abstract

Objective: To investigate the failure patterns of recurrent nasopharyngeal carcinoma (NPC), especially to identify the relationship between the recurrent-prone anatomic structures and the tumor regression sites after the introduction of chemotherapy (IC).

Method: A cohort of 1121 non-metastatic patients with NPC was retrospectively enrolled. The pretreatment and recurrent images of each patient were registered to the planning CT. Tumor regression sites after IC (Vicr) overlapped with recurrent tumor (rGTV) were evaluated for the delineation accuracy and dose sufficiency in marginal failure patients.

Results: A total of 126 (11.24%) experienced tumor recurrence. Re-evaluation of 12 patients with local marginal recurrence, their rGTV within Vicr predominantly located at choanae, sphenoidal sinus, and cavernous sinus. The regression sites did not receive the full 70 Gy but over half receiving with 60Gy.

Conclusion: Analysis from marginal failure that exempts tumor regression sites from GTV or an insufficient prescription dose of less than 70 Gy may contribute to marginal failure.

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鼻咽癌患者的复发模式以及在强度调制放疗时代导致边缘失败不准确划分的风险。

目的研究鼻咽癌复发的失败模式，尤其是确定易复发的解剖结构与化疗（IC）后肿瘤消退部位之间的关系：方法：回顾性纳入1121例非转移性鼻咽癌患者。将每位患者的治疗前和复发图像登记到计划 CT 上。对边缘失败患者IC（Vicr）后与复发肿瘤（rGTV）重叠的肿瘤消退部位进行评估，以确定划分的准确性和剂量的充分性：共有 126 例（11.24%）患者出现肿瘤复发。对 12 例局部边缘复发的患者进行了重新评估，他们在 Vicr 内的 rGTV 主要位于咽喉、蝶窦和海绵窦。这些复发部位没有接受全部 70 Gy 的治疗，但有一半以上接受了 60 Gy 的治疗：结论：从边缘失败分析，将肿瘤回归部位排除在GTV之外或处方剂量不足70Gy可能是导致边缘失败的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.