Nazofarengeal Karsinom Tedavisinde Yoğunluk Ayarlı Radyoterapi ile Kombine Kemoterapinin Akut Yan Etkileri

Objective: It was aimed to evaluate the acute side effects of patients treated in our clinic with nasopharyngeal cancer who underwent definitive chemoradiotherapy. Materials and Methods: 64 patients diagnosed with nasopharyngeal cancer and treated between January 2010 and May 2023 were included in the study. Definitive chemoradiotherapy with intensity modulated radiotherapy was applied to the patients. While 70 Gy of radiotherapy was given to tumor and positive lymph nodes, 60 Gy of radiotherapy was applied to all nasopharynx and bilateral neck lymph nodes. The three rounds of cisplatin 100 mg/m2 (days 1, 22 and 43) or 40 mg/m2 weekly of chemotherapy were used for treatment. The acute side effects of the patients were noted and evaluated. Results: The mean age of the patients was 51.05±14.46 (range: 20-82) years. Of the patients included in the study, 15 (23%) were stage II, 37 (58%) were stage III, and 12 (19%) were stage IV. 41 (64%) patients were male and 23 (36%) were female. In male, the rates of grade 2 and 3 hematological toxicity were 47% and 20%, respectively. In female, the rates of grade 2 and 3 hematological toxicity were 53% and 80%, respectively. There was a significant difference in the rate of hematological toxicity between the 2 groups (z=16.882, p= 0.0001). The rates of grade 2 and 3 hematological toxicity in patients younger than 65 years were 47% and 20%, respectively. In patients older than 65 years, the rates of grade 2 and 3 esophagitis were 53% and 80%, respectively. There was a significant difference in esophagitis rate between the 2 groups (z =18.360, p= 0.0001). Conclusion: Despite the technological treatment devices and methods, the risk of acute toxicity is high in the treatment of nasopharyngeal cancer due to its anatomical location. Our study was found to be compatible with the literature in terms of acute side effects. Strict follow-up and treatment of acute side effects may increase the patient's adherence to treatment, improve quality of life, and increase the effectiveness of treatment.