鼻咽癌腮腺保全IMRT术后腮腺复发患者分析:病例系列和文献综述。

IF 2.7 3区 医学 Q3 ONCOLOGY Strahlentherapie und Onkologie Pub Date : 2024-10-25 DOI:10.1007/s00066-024-02309-4
Sezin Yuce Sari, Melek Tugce Yilmaz, Gozde Yazici, Sepideh Mohammadipour, Gokhan Ozyigit, Ibrahim Gullu, Mustafa Cengiz
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引用次数: 0

摘要

目的:调强放射治疗(IMRT)是鼻咽癌(NPC)的标准治疗方法。调强放射治疗能有效保留腮腺,降低口腔异物感的风险,而口腔异物感是头颈部放射治疗的常见并发症。然而,有必要确定腮腺保留 IMRT(ps-IMRT)技术是否会增加腮腺内/腮腺周的复发率,这也是本研究的主要目的:方法:对1991年至2021年期间确诊为鼻咽癌并接受了明确化疗/放疗(CRT/RT)的患者进行回顾性评估。发现颈动脉内/颈动脉周围复发的患者,并寻找复发的预后因素:共对 746 例患者进行了评估。541名患者接受了二维(2D)-RT治疗,10名患者接受了三维适形RT(3D-CRT)治疗,195名患者接受了ps-IMRT治疗。经过中位 85 个月的随访,1 名(0.18%)接受二维 RT 的患者和 4 名(2%)接受 ps-IMRT 的患者出现了蛛网膜内/外复发。颈动脉内/颈动脉周围复发的中位时间为11.9个月。所有患者均被确诊为同侧颈部二级淋巴结转移大于 2 厘米。此外,所有复发都发生在诊断时颈部阳性的同一侧。3年总生存率、无局部复发生存率和无远处转移生存率分别为80%、40%和60%:结论:颈动脉内/颈动脉周围复发在鼻咽癌中极为罕见。结论:颈内/颈周复发在鼻咽癌中极为罕见,但仍有可能识别和描述特定的风险因素,其中包括二级淋巴结转移,尤其是大于 2 厘米的淋巴结转移,以及诊断时的多结节疾病。
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Analysis of patients with parotid recurrence after parotid-sparing IMRT for nasopharyngeal carcinoma: case series and review of the literature.

Purpose: Intensity-modulated radiotherapy (IMRT) is the standard treatment approach for nasopharyngeal cancer (NPC). IMRT enables effective sparing of the parotid glands and reduces the risk of xerostomia, a common complication of head and neck irradiation. Nevertheless, it is essential to determine whether the parotid-sparing IMRT (ps-IMRT) technique yields increased intra-/periparotid recurrence rates, which constitutes the main purpose of this study.

Methods: Patients with a diagnosis of NPC that received definitive chemoradiotherapy/radiotherapy (CRT/RT) between 1991 and 2021 were evaluated retrospectively. Patients with intra-/periparotid recurrence were detected and prognostic factors for recurrence were sought.

Results: A total of 746 patients were evaluated. Two-dimensional (2D)-RT was applied to 541, 3D conformal RT (3D-CRT) to 10, and ps-IMRT to 195 patients. After a median 85-month follow-up, one (0.18%) patient who received 2D-RT and four (2%) patients who received ps-IMRT experienced an intra-/periparotid recurrence. The median time to intra-/periparotid recurrence was 11.9 months. All patients had been diagnosed with a metastatic lymph node > 2 cm at level II of the ipsilateral neck. In addition, all recurrences occurred on the same side as the positive neck at the time of diagnosis. The 3‑year overall survival, locoregional recurrence-free survival, and distant metastasis-free survival rates were 80%, 40%, and 60%, respectively.

Conclusion: Intra-/periparotid recurrence is extremely rare in NPC. However, it is still possible to identify and characterize particular risk factors, which include a metastatic lymph node at level II, particularly > 2 cm, and multinodal disease at the time of diagnosis.

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来源期刊
CiteScore
5.70
自引率
12.90%
发文量
141
审稿时长
3-8 weeks
期刊介绍: Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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