中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2010年
2期
120-125
,共6页
汪华%李晔雄%王维虎%金晶%宋永文%亓姝楠%王淑莲%刘跃平%刘清峰%王朝阳%刘新帆%戴建荣%余子豪
汪華%李曄雄%王維虎%金晶%宋永文%亓姝楠%王淑蓮%劉躍平%劉清峰%王朝暘%劉新帆%戴建榮%餘子豪
왕화%리엽웅%왕유호%금정%송영문%기주남%왕숙련%류약평%류청봉%왕조양%류신범%대건영%여자호
淋巴瘤,NK/T细胞/放射疗法%放射疗法,调强%治疗结果
淋巴瘤,NK/T細胞/放射療法%放射療法,調彊%治療結果
림파류,NK/T세포/방사요법%방사요법,조강%치료결과
Lymphoma%NK/T-cell/radiotherapy%Radiotherapy,intensity-modulated%Treatment outcome
目的 回顾性分析早期鼻腔和韦氏环NK/T细胞淋巴瘤调强放疗(IMRT)的初步临床结果.方法 48例患者中42例为原发鼻腔NK/T细胞淋巴瘤,6例为韦氏环NK/T细胞淋巴瘤.根据Ann Arbor分期,I_E期37例,Ⅱ_E期11例.22例接受单纯放疗,26例接受放化疗.95%计划靶体积(PTV)处方剂量为50 Gy.放疗副反应分级采用RTOG标准.局部控制率和生存率用Kaplan-Meier法计算.结果 中佗随访18个月,2年局部控制率、无进展生存率和总生存率分别为100%、73%和75%.剂量体积直方图显示PTV最高、平均、最低剂量均值分别为62.6、55.0、20.3 Gy,接受低于95%处方剂量的体积仅占靶体积的2.4%.脑干、脊髓、视交叉、左视神经、右视神经、左晶体和右晶体接受的最高剂量均值分别为43.5、32.7、48.2、50.3、51.3、7.8和7.6 Gy.左腮腺、右腮腺、垂体、左颞颌关节和右颞颌关节接受的平均剂量分别为17.1、16.5、32.5、47.3和46.8 Gy.全组口腔黏膜反应1级37%、2级41%、3级16%;皮肤急性反应1级78%、2级16%;急性口干反应1级65%、2级18%.结论 鼻腔和韦氏环NK/T细胞淋巴瘤IMRT使靶区剂量分布均匀,有效保护了腮腺和其他重要器官,并取得了很好的局部控制率和总生存率.
目的 迴顧性分析早期鼻腔和韋氏環NK/T細胞淋巴瘤調彊放療(IMRT)的初步臨床結果.方法 48例患者中42例為原髮鼻腔NK/T細胞淋巴瘤,6例為韋氏環NK/T細胞淋巴瘤.根據Ann Arbor分期,I_E期37例,Ⅱ_E期11例.22例接受單純放療,26例接受放化療.95%計劃靶體積(PTV)處方劑量為50 Gy.放療副反應分級採用RTOG標準.跼部控製率和生存率用Kaplan-Meier法計算.結果 中佗隨訪18箇月,2年跼部控製率、無進展生存率和總生存率分彆為100%、73%和75%.劑量體積直方圖顯示PTV最高、平均、最低劑量均值分彆為62.6、55.0、20.3 Gy,接受低于95%處方劑量的體積僅佔靶體積的2.4%.腦榦、脊髓、視交扠、左視神經、右視神經、左晶體和右晶體接受的最高劑量均值分彆為43.5、32.7、48.2、50.3、51.3、7.8和7.6 Gy.左腮腺、右腮腺、垂體、左顳頜關節和右顳頜關節接受的平均劑量分彆為17.1、16.5、32.5、47.3和46.8 Gy.全組口腔黏膜反應1級37%、2級41%、3級16%;皮膚急性反應1級78%、2級16%;急性口榦反應1級65%、2級18%.結論 鼻腔和韋氏環NK/T細胞淋巴瘤IMRT使靶區劑量分佈均勻,有效保護瞭腮腺和其他重要器官,併取得瞭很好的跼部控製率和總生存率.
목적 회고성분석조기비강화위씨배NK/T세포림파류조강방료(IMRT)적초보림상결과.방법 48례환자중42례위원발비강NK/T세포림파류,6례위위씨배NK/T세포림파류.근거Ann Arbor분기,I_E기37례,Ⅱ_E기11례.22례접수단순방료,26례접수방화료.95%계화파체적(PTV)처방제량위50 Gy.방료부반응분급채용RTOG표준.국부공제솔화생존솔용Kaplan-Meier법계산.결과 중타수방18개월,2년국부공제솔、무진전생존솔화총생존솔분별위100%、73%화75%.제량체적직방도현시PTV최고、평균、최저제량균치분별위62.6、55.0、20.3 Gy,접수저우95%처방제량적체적부점파체적적2.4%.뇌간、척수、시교차、좌시신경、우시신경、좌정체화우정체접수적최고제량균치분별위43.5、32.7、48.2、50.3、51.3、7.8화7.6 Gy.좌시선、우시선、수체、좌섭합관절화우섭합관절접수적평균제량분별위17.1、16.5、32.5、47.3화46.8 Gy.전조구강점막반응1급37%、2급41%、3급16%;피부급성반응1급78%、2급16%;급성구간반응1급65%、2급18%.결론 비강화위씨배NK/T세포림파류IMRT사파구제량분포균균,유효보호료시선화기타중요기관,병취득료흔호적국부공제솔화총생존솔.
Objective Radiotherapy is the primary therapy for early stage nasal-type NK/T-cell lymphoma of the nasal or Waldeyer ring. This study aimed to investigate the clinical outcome of the disease treated with intensity-modulated radiation therapy (IMRT). Methods From November 2003 to June 2008, 48 patients with nasal or Waldeyer ring NK/T-ceil lymphoma underwent IMRT. The tumors were located in the nasal in 42 patients ,and the Waldeyer ring in 6. According to the Ann Arbor staging system, the disease was stage Ⅰ_E in 37 patients (77%), stage Ⅱ_E in 11 (23%). Of these patients, 22 received radiotherapy alone, the other 26 received combined chemotherapy and radiotherapy. Prescribed radiation dose was defined as a minimun dose of 95% PTV. Acute and late toxicities were scored by Radiation Therapy Oncology Group morbidity criteria. Survival probabilities were estimated using Kaplan-Meier method. Results With a median follow-up of 18 months, the 2-year local control, overall survival and progression-free survival rates were 100%, 75% and 73%, respectively. The average maximum, mean and minimum delivered doses were 62.6 Gy, 55.0 Gy and 20.3 Gy to the PTV. Only 2.4% of the PTV received less than 95% of the prescribed dose. The average maximum dose to the brain, spinal cord, optic chiasm, left optical nerve, right optical nerve, left len and right len was 43.5 Gy, 32. 7 Gy, 48.2 Gy, 50. 3 Gy, 51.3 Gy, 7. 8 Gy and 7.6 Gy, respectively. The average mean dose to the left parotid, right parotid, pituitary, left T-M joint and right T- M joint was 17. 1 Gy , 16. 5 Gy , 32. 5 Gy , 47.3 Gy and 46. 8 Gy , respectively. Acute mucositis was observed in 37% of patients with Grade 1, 41% with Grade 2, and 16% with Grade 3. Skin toxicity was observed in 78% of patients with Grade 1 and 16% with Grade 2. Acute xerestoma was observed in 65% of patients with Grade 1 and 18% with Grade 2. Conclusions IMRT provids excellent tumor target coverage and reduces the dose to the critical normal tissues such as the salivary glands. Longer follow-up is needed to assess the long-term overall survival and local control.
