鼻咽癌IMRT放射性溃疡临床及剂量因素分析

doi:10.3760/cma.j.issn.1004-4221.2016.05.004

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Abstract Objective To investigate the influencing factors for postradiation nasopharyngeal necrosis (PRNN) by analyzing clinical characteristics, prognosis, and dosimetry of PRNN after initial intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods A retrospective analysis was performed among 1217 patients with NPC who received initial IMRT from 2001 to 2013. Twenty-one patients were diagnosed with PRNN by clinical symptoms, endoscopy, magnetic resonance imaging, and pathological evidence (not including local recurrence). The clinical characteristics and prognosis were summarized and the radiotherapy plans were reassessed for dosimetric evaluation. Results In the 21 patients with PRNN, 17 were male and 4 female;one patient was in stage T₂, 3 in stage T₃, and 17 in stage T₄. The median volume of gross tumor was 83 cm³. All patients received radiotherapy with a prescribed dose of 73.92 Gy except one patient with stage T₂ disease who received a prescribed dose of 69.96 Gy. The time to PRNN after radiotherapy ranged between 1.8 and 21.9 months (median time=6.2 months). The incidence of massive nasopharyngeal bleeding was 48%(10/21). In the 21 patients, 6 recovered form PRNN, 15 remained ill, and 8 patients died, consisting of 4 who died of massive nasopharyngeal bleeding, 3 of cachexia with multiple organ failure, and 1 of multiple bone metastases. Conclusions PRNN is one of the severe adverse reactions after IMRT for NPC. The development of PRNN is related to advanced T stage, large tumor volume, poor nutritional status, infection, radiotherapy dose, and intense treatment. Massive nasopharyngeal bleeding and cachexia are the primary causes of death in patients with PRNN.

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	Articles by authors
	Yin Zhenzhen
	Gao Li
	Luo Jingwei
	Yi Junlin
	Huang Xiaodong
	Wang Kai
	Qu Yuan
	Zhang Shiping
	Li Suyan
	Xiao Jianping
	Xu Guozhen

Key words： Nasopharyngeal neoplasms/three-dimensional radiotherapy Radiation nasopharyngeal necrosis Factor analysis

Received: 16 April 2015

Corresponding Authors: Gao Li,Email:li_gao2008@outlook.com

Cite this article:

Yin Zhenzhen,Gao Li,Luo Jingwei et al. An analysis of clinical and dosimetric factors for postradiation nasopharyngeal necrosis in intensity-modulated radiotherapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 438-442.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.05.004 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I5/438

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