Clinical role of ^(18)F-FDG PET/CT-based simultaneous modulated accelerated radiotherapy treatment planning for locally advanced nasopharyngeal carcinoma  

作　　者：Jianshe Wang Tianyou Tang Jing Xu Andrew Z.Wang Liang Li Junnian Zheng Longzhen Zhang 

机构地区：[1]Department of Radiation Oncology, The Affiliated Hospital of Xuzhou Medical College, Cancer Institute of Xuzhou Medical College [2]Functional Lab, Xuzhou Medical College [3]Department of Radiation Oncology, The University of North Carolina-Chapel Hill [4]Jiangsu Key Laboratory of Biological Cancer Therapy, Xuzhou Medical College

出　　处：《Oncology and Translational Medicine》2015年第6期264-270,共7页肿瘤学与转化医学（英文版）

基　　金：Supported by grants from the National Natural Science Foundation of China(No.81071831);Jiangsu Provincial Health Bureau issues(No.H201021);Xuzhou City Science and Technology Bureau issues(No.XF10C082);Jiangsu Province Natural Science Foundation of China(No.BK20131131)

摘　　要：Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography （PET/CT）-guided dose escalation radio- therapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of locally ad- vanced nasopharyngeal carcinoma （NPC）. Methods Atotal of 48 patients with stage IIl-IVa NPC were recruited and randomly administered PET/CT- guided dose escalation chemoradiotherapy （group A） or conventional chemoradiotherapy （group B）. The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray （Gy） in 32 fractions （f） to the gross target volume （GTV）： planning target volume （PTV） 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous （IV） on days 1-4] and docetaxel （75 mg/m2 IV on days 1 and 8） administered during treatment weeks 1 and 4. All patients received 2-4 cycles of adjuvant chemotherapy of the same dose and drug regimen. Results The use of fluorine-18-fluorodeoxyglucose （18F-FDG） PET/CT significantly reduced the treat- ment volume delineation of the GTV in 83.3% （20/24） of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively （P = 0.019）. The 5-year disease free survival （DFS） rates were 95.8% and 75.0%, respectively （P = 0.018）. The 5-year local progression-free survival and DFS rates were significantly different. The 5-year overall survival （OS） rates were 95.8% and 79.2%, re- spectively. Differences in OS improvement were insignificant （P = 0.079）. Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1-2 skin dystrophy, xerostomia, subcutaObjective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography(PET/CT)-guided dose escalation radiotherapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of locally advanced nasopharyngeal carcinoma(NPC).Methods A total of 48 patients with stage III–IVa NPC were recruited and randomly administered PET/CTguided dose escalation chemoradiotherapy(group A) or conventional chemoradiotherapy(group B). The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray(Gy) in 32 fractions(f) to the gross target volume(GTV): planning target volume(PTV) 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous(IV) on days 1–4] and docetaxel(75 mg/m2 IV on days 1 and 8) administered during treatment weeks 1 and 4. All patients received 2–4 cycles of adjuvant chemotherapy of the same dose and drug regimen.Results The use of fluorine-18-fluorodeoxyglucose(^(18)F-FDG) PET/CT significantly reduced the treatment volume delineation of the GTV in 83.3%(20/24) of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively(P = 0.019). The 5-year disease free survival(DFS) rates were 95.8% and 75.0%, respectively(P = 0.018). The 5-year local progression-free survival and DFS rates were significantly different. The 5-year overall survival(OS) rates were 95.8% and 79.2%, respectively. Differences in OS improvement were insignificant(P = 0.079). Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1–2 skin dystrophy, xerostomia, subcutaneous fibrosis, and hearing loss. There were no cases of grade 4 late toxicity.Conclusi

关 键 词：nasopharyngeal carcinoma （NPC） simultaneous modulated accelerated radiotherapy in-tensity-modulated radiotherapy positron emission tomography/computed tomography （PET/CT） fluorine-18-fluorodeoxyglucose （18F-FDG） 

分 类 号：R739.63[医药卫生—肿瘤] R730.55[医药卫生—临床医学]