同步推量与超分割调强放疗同步化疗靶向治疗局部晚期鼻咽癌的临床效果

Clinical Effect of Synchronized Push Volume and Hyper-segmentation Intensity Modulated Radiotherapy with Synchronized Chemotherapy Targeted Treatment for Locally Advanced Nasopharyngeal Carcinoma

目的:对比同步推量与超分割调强放疗同步化疗治疗局部晚期鼻咽癌的临床疗效及毒性反应。方法:选取2017年1月-2020年6月惠州市第六人民医院肿瘤科收治的经病理确诊且资料完整的初治局部晚期鼻咽癌患者63例为观察对象。采用诱导化疗后放疗同期化疗靶向治疗,据分割模式将患者分成同步推量组32例与超分割组31例,分析其生存状况与毒性反应。结果:同步推量组与超分割组1年无局部区域复发生存、无远处转移生存、无疾病进展生存、总生存比较,差异无统计学意义(P>0.05)。超分割组1、2级与3级急性口腔黏膜炎、放射性皮炎发生率比较,差异有统计学意义(P<0.05)。结论:超分割较之同步推量调强放疗同步化疗治疗局部晚期鼻咽癌并未改善预后生存状况,而3级急性期急性黏膜炎与放射性皮炎发生率则较高,差异具统计学意义。

Objective:To compare the clinical efficacy and toxic reactions of synchronous chemotherapy with synchronized push volume and hyper-segmentation intensity modulated radiotherapy for locally advanced nasopharyngeal carcinoma.Methods:Sixtythree patients with pathologically confirmed and complete data of primary locally advanced nasopharyngeal cancer admitted to the Department of Oncology of Huizhou Sixth People's Hospital from January 2017 to June 2020 were selected as observation subjects.And concurrent chemoradiotherapy combined with targeted therapy after induction chemotherapy were performed,the patients were divided into thirty-two cases in the synchronized push volume group and thirty-one cases in the super-segmentation group according to the segmentation pattern,and their survival status and toxic reactions were analyzed.Results:There was no statistically significant difference between the 1-year local recurrence-free survival,distant metastasis-free survival,diseaseprogression-free survival,and overall survival in the synchronized push volume group compared with the hyper-segmentation group(P>0.05).When comparing the incidence of grade 1 and 2 versus grade 3 acute oral mucositis and radiation dermatitis in the hyper-segmentation group,the differences were statistically significant(P<0.05).Conclusion:Hyper-segmentation did not improve the prognosis of survival compared with simultaneous push volume intensity modulated radiotherapy and chemotherapy for locally advanced nasopharyngeal carcinoma,while the incidence of acute mucositis and radiation dermatitis in grade 3 acute stage was higher,and the difference was statistically significant.