[an error occurred while processing this directive] | [an error occurred while processing this directive]
Study on delineation of tumor volume of primary locally advanced nasopharyngeal carcinoma after induction chemotherapy
LONG Jin-hua*, DONG Shi, JIN Feng, WU Wei-li, GAN Jia-ying, CHEN Hai-xia, LI Yuan-yuan, GONG Xiu-yun
*Department of Head and Neck Oncology, Cancer Hospital of Guizhou Province, Guiyang 550004, China Corresponding author:JIN Feng, Email:jinf8865@yahoo.com.cn
Abstract Objective To investigate the delineation of gross tumor volume (GTV) in locally advanced nasopharyngeal carcinoma (LANC) according to imageological changes before and after induction chemotherapy (IC) in order to decrease high dose area and protect normal tissue better. Methods Between Mar 2010 to Jan 2011, 11 patients with LANC were enrolled and treated with TPF regimen followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy, target volumes were delineated based on fused CT imaging before and after IC following project determination. Tumor target volumes after and before IC were respectively delineated according to imaging tumor residues and were overlaid by CTVnx in order to ensure radical doses for the imaging tumor volume before IC, the resulting differences of tumor target volumes of IC before and after were measured and analyzed by paired t-test. Results Before and after IC, the average volumes of GTVnx were respectively 44.72 cm3 and 28.87(t=3.89,P=0.003), the average volumes of GTVnd were respectively 32.76 cm3 and 19.82 cm3(t=2.47,P=0.033), the volumes of maximum dose area in brainstem and spinal cord as well as eyeball decreased (t=2.93-4.59,all P<0.05). Conclusions LANC treated by 3 cycle TPF regimen followed by IMRT with concurrent chemotherapy showes significant shrinkage of tumor volume. The volume of high dose region which caused by normally recovered tissues were decreased by re-delineation of target volume in brainstem and spinal cord as well as eyeball of CT images after IC.
LONG Jin-hua*,DONG Shi,JIN Feng et al. Study on delineation of tumor volume of primary locally advanced nasopharyngeal carcinoma after induction chemotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 417-419.
LONG Jin-hua*,DONG Shi,JIN Feng et al. Study on delineation of tumor volume of primary locally advanced nasopharyngeal carcinoma after induction chemotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 417-419.
[1] Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med,2007,357:1705-1715. [2] 洪明晃,郭翔. 鼻咽癌.北京:中国医药科技出版社,2003. [3] 金风,欧阳金陵,董洪敏. 鼻咽癌DDP+5Fu/CF方案时辰化疗的临床前瞻性随机研究.中国肿瘤临床,2004,31:1123-1125. [4] Lee AW, Lau KY, Hung WM, et al. Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma. Radiother Oncol,2008,87:204-210. [5] Langendijk JA, Leemans CR, Buter J, et al. The additionalvalue of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma:a meta-analysis of the published literature. J Clin Oncol,2004,22:4604-4612. [6] Baujat B, Audry H, Bourhis J, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma:an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys,2006,64:47-56. [7] Rischin D, Corry J, Smith J, et al. Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation. J Clin Oncol,2002,20:1845-1852. [8] Ferrari D, Chiesa F, Codeca C, et al. Locoregionally advanced nasopharyngeal carcinoma:induction chemotherapy with cisplatin and 5-fluorouracil followed by radiotherapy and concurrentcisplatin:a phase Ⅱ study. Oncology,2008,74:158-166. [9] Airoldi M, Gabriele P, Gabriele AM, et al. Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a non-endemic population. Radiother Oncol,2009,27:105-110. [10] 潘建基,张瑜,林少俊,等.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识.中华放射肿瘤学杂志,2011,20:267-269. [11] 沈春英,胡超苏,顾雅佳,等.鼻咽癌原发肿瘤容积与放射治疗疗效关系的研究.中华放射肿瘤学杂志,2004,13:73-77. [12] Chen MK, Chen TH, Liu JP, et al.Better prediction of prognosis for patients with nasopharyngeal carcinoma using primary tumor volume.Cancer,2004,100:2160-2166. [13] 潘建基,韩露. 鼻咽癌缩小临床靶体积调强放疗疗效探讨. 中华放射肿瘤学杂志,2010,19:283-287. [14] 余湛,罗伟,周琪超.诱导化疗后局部晚期鼻咽癌调强放疗肿瘤靶区勾画方式改变对剂量分布和临床疗效的影响.癌症,2009,28:1132-1137.