采用 IMRT 和螺旋断层疗法治疗头颈癌患者的急性毒性、总体治疗时间和生活质量比较

Q3 Medicine
The gulf journal of oncology Pub Date : 2024-05-01
Yashaswini B R, Kumara Swamy, Chundru Swaroopa, Vikram Maiya
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引用次数: 0

摘要

导言:过去二十年来,放射治疗计划和给药方面的技术革新极大地改变了放射治疗的实践。据报道,与传统的基于直列加速器的 IMRT 相比,螺旋断层放射治疗可改善剂量均匀性,更好地保护关键结构。本研究旨在比较采用 IMRT 和螺旋断层疗法治疗的头颈部癌症患者在治疗期间的急性毒性(皮肤、粘膜、唾液腺和血液学)和总体治疗时间,并评估两组患者在治疗期间的生活质量:研究涉及 30 名经组织学证实的头颈部鳞状细胞癌患者。他们同时接受化放疗,剂量为 60-70 Gray,分 30-35 次进行。研究包括两部分,即标准 IMRT 和 Tomotherapy 部分。15 名连续患者接受了 IMRT 治疗,15 名患者接受了螺旋断层治疗,并同时进行了化疗。计划完成后,对计划进行评估,并将目标和危险器官的剂量制成表格。根据 RTOG 标准,在治疗过程中每周对患者的急性毒性(皮肤反应、粘膜炎、口腔干燥症、血液毒性)进行评估。在放疗第 1 天、第 21 天和结束时,使用当地语言的 FACT/ NCCN HNSI 问卷对患者的生活质量进行评估:结果:两组患者均主要出现 2-3 级皮肤反应、粘膜炎、贫血、白细胞减少和血小板减少。从放疗开始到放疗结束的治疗时间从 39 天到 68 天不等。大多数患者在 50-56 天内完成放疗。平均生活质量评分在 IMRT 治疗组和断层治疗组之间没有太大差异:研究结果表明,IMRT 和螺旋断层疗法在总体治疗时间、急性毒性(皮肤反应、口腔干燥症、粘膜炎和血液学毒性)以及放疗期间患者的生活质量方面均无明显统计学差异。从减少急性毒性、缩短总体治疗时间和提高患者生活质量的角度来看,断层放疗比综合放射治疗在剂量学方面的优势并没有转化为临床获益:头颈癌、IMRT、断层治疗、RTOG、毒性、FACT/ NCCN HNSI、生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Acute Toxicities, Overall Treatment Time and Quality of Life in Head and Neck Cancer Patients Treated with IMRT and Helical Tomotherapy.

Introduction: Technical innovations in radiation therapy treatment planning and delivery over the last two decades have changed the practice of radiation therapy dramatically. The benefit of improved dose homogeneity and better sparing of critical structures in helical tomotherapy compared with conventional linac-based IMRT has been reported. This study was conducted to compare acute toxicities (skin, mucous membrane, salivary gland and hematological) during treatment and overall treatment time in Head and Neck Cancer patients treated with IMRT and Helical Tomotherapy and to assess the quality of life of patients during treatment between two groups.

Materials and methods: The study involved thirty patients with histologically proven Squamous cell carcinomas of Head and Neck. They were treated with concurrent chemoradiotherapy, to a dose of 60-70 Gray in 30-35 fractions. The study consists of 2 arms which are standard IMRT and Tomotherapy arm. Fifteen consecutive patients were treated under IMRT and 15 patients were treated under Helical tomotherapy, along with concurrent chemotherapy. After completion of planning, plans were evaluated and dose to the targets, organs at risk were tabulated. Patients were assessed weekly for acute toxicities (skin reactions, mucositis, xerostomia, haematological toxicities) during the course of the treatment as per RTOG criteria. Quality of life of patients were assessed using FACT/ NCCN HNSI questionnaire in local language at day 1, day 21 and at completion of radiotherapy.

Results: Grade 2-3 skin reactions, mucositis, anemia, leukopenia and thrombocytopenia were predominant in both arms. Treatment time from start of radiotherapy to completion of radiotherapy varied from 39 days to 68 days. Majority of patients completed radiotherapy within 50-56 days. Mean quality of life score did not show much difference between IMRT and tomotherapy arms.

Conclusion: The study did not show any statistically significant difference in overall treatment time, acute toxicities- skin reactions, xerostomia, mucositis& hematological toxicities and quality of life of patients during radiotherapy between IMRT and Helical Tomotherapy. Dosimetric benefits of Tomotherapy over IMRT do not translate into clinical benefit in terms of reduced acute toxicities, lesser overall treatment time and better quality of life of patients.

Key words: Head and Neck Carcinoma, IMRT, Tomotherapy, RTOG, toxicity, FACT/ NCCN HNSI, quality of life.

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The gulf journal of oncology
The gulf journal of oncology Medicine-Medicine (all)
CiteScore
0.90
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