Objective To comparatively analyze the acute adverse reactions of helical tomotherapy (HT) and intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods A total of 100 NPC patients treated with radiotherapy were selected and divided into the HT group (n=50) and IMRT group (n=50). All patients were treated with concurrent chemoradiotherapy. The prescription dose of radiotherapy was DT68.2-73.8 Gy/30-34F. The severity of acute adverse reactions of skin, oral mucosa, salivary glands and esophagus was evaluated with the established RTOG criteria. The differences between two groups were evaluated by paired t-test. Results The dose of organs at risk (OARs) in the HT group was significantly lower than that in the IMRT group (P<0.05),whereas the dose of target area of PTVnx, PTVnd (left) and PTVnd (right) did not significantly differ between two groups (all P>0.05). In the HT group, the incidence rate of grade 0-3 acute adverse reactions in the skin, oral mucosa, salivary glands and esophagus were (14%,68%,18%,0%),(10%,54%,36%,0%),(0%,74%,26%,0%) and (10%,60%,28%,2%), respectively. In the IMRT group, the corresponding results were (0%,52%,48%,0%),(0%,58%,42%,0%),(0%,28%,72%,0%) and (0,40%,60%,0%), respectively. The severity of acute adverse reactions of skin, salivary glands and esophagus in the HT group was slighter than those in the IMRT group (all P<0.05), the acute adverse reactions in the oral mucosa were similar between two groups (P>0.05). In the HT group, the onset time of acute adverse reactions in the skin was later than that in the IMRT group (P<0.05), and the onset time of other adverse reactions was similar between two groups (all P>0.05). Conclusions Both HT and IMRT can meet the requirements of the dose distribution in the target area for NPC, whereas HT is superior to IMRT in terms of the protection of OARs protection, the severity and onset time of acute adverse reactions.
Corresponding Authors:
Lin Chengguang, Email:linchg@sysucc.org.cn
Cite this article:
Liu Hui,He Huilang,Chen Xuanguang et al. Comparison of acute adverse reactions between helical tomotherapy and intensity-modulated radiation therapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(8): 580-583.
Liu Hui,He Huilang,Chen Xuanguang et al. Comparison of acute adverse reactions between helical tomotherapy and intensity-modulated radiation therapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(8): 580-583.
[1] 林冬梅,高黎. 鼻咽癌[A]//殷蔚伯,谷铣之. 肿瘤放疗学[M].4版. 北京:中国协和医科大学出版社,2008:443-480.
Lin DM,Gao Li. Nasopharyngeal carcinoma[A]//Yin WB,Gu XZ. Raiation Oncology[M].3 ed. Beijing:Peking union medical university press,2002:551-563.
[2] Mohan R,Wu Q,Manning M,et al. Radiobiological considerations in the design of fractionation strategies for intensity-modulated radiotherapy of head and neck cancers[J]. Int J Radiat Oncol Biol Phys,2000,46(3):619-630. DOI:10.1016/s0360-3016(99)00438-1.
[3] Jeraj R,Mackie TR,Balog J,et al. Radiation characteristics of helical tomotherapy[J]. Med Phys,2004,31(2):396-404. DOI:10.1118/1.1639148.
[4] Beavis AW. Is tomotherapy the future of IMRT?[J]. Br J Radiol,2014,77(916):285. DOI:10.1259/bjr/22666727.
[5] Mackie TR,Balog J,Ruchala K,et al. Tomotherapy[J]. Semin Radiat Oncol,1999,9(1):108-117. DOI:10.1016/S1053-4296(99)80058-7.
[6] Sheng K,Molloy JA,Read PW. Intensity-modulated radiation therapy (IMRT) dosimetry of the head and neck:a comparison of treatment plans using linear accelerator-based IMRT and helical tomotherapy[J]. Int J Radiat Oncol Biol Phys,2006,65(3):917-923. DOI:10.1016/j.ijrobp.2006.02.038.
[7] 杨静,杨双燕. 鼻咽癌螺旋断层放疗与调强放疗的剂量学比较[J]. 医学理论与实践,2016,28(15):15-18. DOI:10.3969/j.issn.1674-1633.2013.12.006.
Yang J,Yang SY. Dosimetry Comparison of spiral tomography and intensity modulated radiotherapy for nasopharyngeal carcinoma[J]. Med Theor Pract,2016,28(15):15-18. DOI:10.3969/j.issn.1674-1633.2013.12.006.
[8] Bauman G,Yartsev S,Coad T,et al. Helical tomotherapy for craniospinal radiation.[J]. Br J Radiol,2005,78(930):548-552. DOI:10.1259/bjr/53491625.
[9] 杜镭,马林,周桂霞,等. 螺旋断层放疗45例鼻咽癌近期临床观察[J]. 解放军医学院学报,2009,30(3):311-314.
Du L,Ma L,Zhou GX,et al. Recent clinical observation of 45 cases of nasopharyngeal carcinoma with spiral tomography[J]. J PLA Med Coll,2009,30(3):311-314.
[10] 彭丽莎,王枫,张静. 螺旋断层放疗鼻咽癌22例近期疗效观察[J]. 山东医药,2015(21):100-101. DOI:10.3969/j.issn.1002-266X.2015.21.041.
Peng LS,Wang F,Zhou GX,et al. Recent observation on the curative effect of 22 cases of nasopharyngeal carcinoma treated by spiral tomography[J]. Shandong Med,2015(21):100-101. DOI:10.3969/j.issn.1002-266X.2015.21.041.
[11] 韩非. 正常组织临床放射生物学[A]//崔念基. 实用临床放射肿瘤学[M]. 广州:中山大学出版社,2005:123-143.
Han Fei. Clinical radiobiology of normal tissue[A]//Cui NJ. Practical Clinical radiation Oncology[M]. Guangzhou:Sun Yat-sen university press,2005:123-143.
[12] 陈佳文,曹春华.96例鼻咽癌患者放疗不良反应的临床分析[J]. 现代肿瘤医学,2013,21(5):1013-1014. DOI:10.3969/j.issn.1672-4992.2013.05.26.
Chen JW,Cao CH. Clinical analysis of adverse reactions in radiotherapy in 96 patients with nasopharyngeal carcinoma[J]. Mod Oncol,2013,21(5):1013-1014. DOI:10.3969/j.issn.1672-4992.2013.05.26.
[13] 何汇朗,刘辉明,许森奎,等. 乳腺癌根治术后大分割放疗与常规分割放疗的急性不良反应比较[J]. 国际医药卫生导报,2016,22(5):625-628. DOI:10.3760/cma.j.issn.1007-1245.2016.05.010.
He HL,Liu HM,Xu SK,et al. Comparison of acute adverse reactions between large segmented radiotherapy and conventional segmented radiotherapy after radical mastectomy for breast cancer[J]. Int Med Heal Guid,2016,22(5):625-628. DOI:10.3760/cma.j.issn.1007-1245.2016.05.010.