鼻咽癌接受调强放疗与三维适形放疗技术的治疗结局：一个发展中国家的单中心经验
Treatment Outcomes in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy Versus 3D-Conformal Radiotherapy Techniques: A Single-Center Experience in a Developing Country.
文献信息
| PMID | 42802385 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Pooria Mousavi |
| 作者单位 | Department of Radiation Oncology, Cancer Institute, IKHC, Tehran University of Medical Sciences, Tehran, Iran. |
| 期刊 | Asia-Pacific journal of clinical oncology |
| SCI 分区 | Q3 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
背景： 放疗（RT）是非转移性鼻咽癌（NPC）的主要治疗方法。虽然调强放疗（IMRT）在富裕地区更受青睐，但三维适形放疗（3D-CRT）在资源有限的环境中仍然常见。本研究评估了IMRT与3D-CRT治疗NPC的疗效，重点关注生存、肿瘤控制和毒性。
方法： 这项回顾性队列研究于2007年至2024年在伊朗癌症研究所进行，评估了非转移性鼻咽癌（NPC）患者。从医疗记录和随访电话访谈中获取人口学数据、治疗细节、复发率、转移和生存信息。治疗相关并发症根据不良事件通用术语标准v5.0（2017）进行分类。使用R软件进行统计分析，并附有p值。
结果： 共纳入176例患者，其中124例接受3D-CRT，52例接受IMRT。IMRT与吞咽困难发生率显著降低以及牙关紧闭、吞咽困难、口干和听力障碍的严重程度减轻相关。两组在颈部僵硬或口腔黏膜炎的发生率或严重程度方面未观察到显著差异。关于治疗结果，无病生存期或转移无病生存期未见统计学显著差异。总生存期显示出有利于IMRT的非显著趋势。
结论： 与3D-CRT相比，IMRT显著减少了若干治疗相关并发症；然而，它尚未提供明确的生存优势。需要延长随访和前瞻性研究来阐明两种方法在长期疗效上的差异。
试验注册： 不适用。
英文摘要
BACKGROUND: Radiotherapy (RT) is the primary treatment for non-metastatic nasopharyngeal cancer (NPC). While intensity-modulated RT (IMRT) is preferred in wealthy regions, three-dimensional conformal RT (3D-CRT) remains common in resource-limited settings. This study evaluated IMRT versus 3D-CRT for NPC, focusing on survival, tumor control, and toxicities.
METHODS: This retrospective cohort study, performed at the Cancer Institute of Iran from 2007 to 2024, assessed individuals with non-metastatic nasopharyngeal carcinoma (NPC). Demographic data, treatment details, recurrence rates, metastasis, and survival information were obtained from medical records and follow-up telephone interviews. Complications associated with treatment were classified according to Common Terminology Criteria for Adverse Events v5.0 (2017). Statistical studies were conducted utilizing R software, accompanied with a p-value.
RESULTS: A total of 176 patients were enrolled, with 124 receiving 3D-CRT and 52 receiving IMRT. IMRT was associated with a significantly reduced incidence of dysphagia and with reduced severity of trismus, dysphagia, xerostomia, and hearing impairment. No significant differences were observed in the incidence or severity of neck stiffness or oral mucositis between the two groups. Concerning treatment results, no statistically significant differences were seen in disease-free survival or metastasis-free survival. The overall survival exhibited a non-significant trend favoring IMRT.
CONCLUSION: IMRT markedly diminishes several treatment-associated complications in comparison to 3D-CRT; however, it does not provide a definitive survival advantage yet. Extended follow-up and prospective investigations are necessary to elucidate the disparities in long-term efficacy between the two approaches.
TRIAL REGISTRATION: Not applicable.