VMAT与s-IMRT对鼻咽癌患者无进展生存率及并发症发生率的影响  

Effect of VMAT and s-IMRT on Progression Free Survival Rate and Complication Rate in Patients with Nasopharyngeal Carcinoma

作　　者：贾彦召[1] 余杰[1] 饶石磊[1] 曹华琳[2] JIA Yanzhao;YU Jie;RAO Shilei;CAO Hualin(Department of Radiotherapy,Nanyang Central Hospital,Nanyang 473000,China;Department of Otolaryngology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院放射治疗科,河南南阳473000 [2]南阳市中心医院耳鼻咽喉科,河南南阳473000

出　　处：《河南医学研究》2025年第4期628-631,共4页Henan Medical Research

摘　　要：目的分析容积旋转调强放疗(VMAT)与静态调强放疗(s-IMRT)对鼻咽癌患者无进展生存率及并发症发生率的影响。方法回顾性分析2021年2月至2022年12月南阳市中心医院收治的63例鼻咽癌患者的资料,将接受VMAT的40例患者列为VMAT组,将接受s-IMRT的23例患者列为s-IMRT组。比较两组临床疗效、无进展生存率、机器跳数、出束时间、甲状腺功能[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)]、血清纤维化指标[Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、透明质酸(HA)]、并发症发生情况。结果两组临床总有效率差异无统计学意义(P>0.05);治疗后VMAT组机器跳数较s-IMRT组低,出束时间较s-IMRT组短(P<0.05);VMAT组治疗后FT 3、FT 4高于s-IMRT组,PCⅢ、LN、HA、Ⅳ-C及TSH低于s-IMRT组(P<0.05);VMAT组放射性皮炎、口腔黏膜损伤、口干、吞咽困难、听力下降发生率低于s-IMRT组(P<0.05);VMAT组6个月、1 a无进展生存率均高于s-IMRT组(P<0.05)。结论对比s-IMRT,VMAT应用于鼻咽癌患者治疗有助于改善治疗效率,减轻对甲状腺功能的影响,改善血清纤维化,还可减少并发症发生,提高患者无进展生存率。Objective To analyze the effect of volumetric modulated arc therapy(VMAT)and static intensity modulated radiotherapy(s-IMRT)on progression free survival rate and complication rate in patients with nasopharyngeal carcinoma.Methods The data of 63 patients with nasopharyngeal carcinoma in Nanyang Central Hospital from February 2021 to December 2022 were retrospectively analyzed.Among them,40 patients with VMAT were classified as VMAT group,and 23 patients with s-IMRT were classified as s-IMRT group.The clinical efficacy,progression free survival rate,number of machine hops,beam exit time,thyroid function[thyroid stimulating hormone(TSH),free triiodothyronine(FT 3),free thyroxine(FT 4)],serum fibrosis indexes[typeⅣcollagen(Ⅳ-C),laminin(LN),typeⅢprocollagen(PCⅢ),hyaluronic acid(HA)]and complications were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the two clinical groups(P>0.05).After treatment,the number of machine hops in VMAT group was lower than that in s-IMRT group,and the time of beam exit was shorter than that in s-IMRT group(P<0.05).After treatment,FT 3 and FT 4 in VMAT group were higher than those in s-IMRT group,while PCⅢ,LN,HA,Ⅳ-C and TSH in VMAT group were lower than those in s-IMRT group(P<0.05).The incidence of radiodermatitis,oral mucosal damage,dry mouth,dysphagia,and hearing loss were lower in the VMAT group than in the s-IMRT group(P<0.05).The half year and one year progression free survival rates in VMAT group were higher than those in s-IMRT group(P<0.05).Conclusion Compared with s-IMRT,VMAT in the treatment of nasopharyngeal carcinoma patients can improve the treatment efficiency,reduce the impact on thyroid function,improve serum fibrosis,reduce the incidence of complications,and improve the progression free survival rate.

关 键 词：鼻咽癌 容积旋转调强放疗 静态调强放疗 无进展生存率 并发症 甲状腺功能 纤维化 

分 类 号：R739.6[医药卫生—肿瘤]