Impact of Radiation Therapy Techniques on Hippocampal Doses and Psychological Status in Patients With Nasopharyngeal Carcinoma.

IF 2.5 4区医学 Q3 ONCOLOGY Cancer Management and Research Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI:10.2147/CMAR.S492449

Xiujuan Gai, Shiqi Huang, Jiang Zeng, Jun Chen, Feng Liu, Shan Li, Wenlong Lv, Feibao Guo, Chuanshu Cai, Jinsheng Hong, Li Su

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Abstract

Purpose: To investigate the impact of Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) on hippocampal radiation dosage and psychological status in patients newly diagnosed with nasopharyngeal carcinoma (NPC).

Patients and methods: A retrospective analysis was conducted on 269 NPC patients who received initial treatment between January 2013 and April 2022. Patients were categorized into the IMRT group and the VMAT group based on the radiotherapy technique employed. The differences in hippocampal doses for NPC patients at different stages between the two groups were analyzed. The Hospital Anxiety and Depression Scale (HADS) was used to assess patients' anxiety and depression states. Before radiotherapy, patients with anxiety scores (HADS-A) between 0 and 10 points were included to analyze the differences in anxiety occurrence rates between IMRT and VMAT techniques. Similarly, patients with depression scores (HADS-D) between 0 and 10 points were included to analyze the differences in depression occurrence rates between the two radiotherapy techniques.

Results: In patients with T1-2 stage, those treated with IMRT had significantly higher hippocampal doses compared to those treated with VMAT. Furthermore, after radiotherapy, the occurrence rates of anxiety (HADS-A ≥ 11) and depression (HADS-D ≥ 11) in the IMRT group were 27.3% and 19.5%, respectively, while in the VMAT group, they were 9.5% and 7.4%, both showing significant statistical differences (P=0.010, P=0.035). However, there was no significant correlation between the radiotherapy technique and anxiety or depression occurrence rates in patients with T3-4 stage. Additionally, age and gender exhibited certain influences on psychological status.

Conclusion: In the absence of hippocampal protection, opting for a VMAT treatment plan over IMRT may potentially reduce the incidence of anxiety and depression. This perspective offers new insights for optimizing treatment strategies and improving quality of life.

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放射治疗技术对鼻咽癌患者海马剂量和心理状态的影响。

目的：探讨调强放射治疗（IMRT）和体积调弧放射治疗（VMAT）对鼻咽癌（NPC）新诊断患者海马放射剂量和心理状态的影响。患者和方法：对2013年1月至2022年4月期间接受初次治疗的269例鼻咽癌患者进行回顾性分析。根据采用的放疗技术将患者分为IMRT组和VMAT组。分析两组不同阶段鼻咽癌患者海马剂量的差异。采用医院焦虑抑郁量表（HADS）评估患者的焦虑抑郁状态。放疗前纳入焦虑评分（HADS-A）在0 ~ 10分之间的患者，分析IMRT与VMAT技术之间焦虑发生率的差异。同样，纳入抑郁评分（HADS-D）在0 - 10分之间的患者，分析两种放疗技术之间抑郁发生率的差异。结果：在T1-2期患者中，IMRT治疗组海马剂量明显高于VMAT治疗组。放疗后，IMRT组焦虑（HADS-A≥11）、抑郁（HADS-D≥11）发生率分别为27.3%、19.5%，VMAT组为9.5%、7.4%，差异均有统计学意义（P=0.010、P=0.035）。而放疗技术与T3-4期患者焦虑、抑郁发生率无显著相关性。此外，年龄和性别对心理状态有一定的影响。结论：在缺乏海马保护的情况下，选择VMAT治疗方案而不是IMRT治疗方案可能会潜在地减少焦虑和抑郁的发生率。这一观点为优化治疗策略和提高生活质量提供了新的见解。

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

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.