T<sub>1-2</sub>期鼻咽癌RTOG推荐靶区与中国推荐靶区IMRT计划之间后组颅神经NTCP差异性分析

doi:10.3760/cma.j.issn.1004-4221.2016.06.002

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (752 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To investigate the difference in normal tissue complication probability (NTCP) of lower cranial nerves (LCNs) between target volumes recommended by Radiation Therapy Oncology Group (RTOG) and China in intensity-modulated radiotherapy (IMRT) for T_1-2 nasopharyngeal carcinoma (NPC), and to provide the evidence of dose-volume effect for the protection of LCNs in IMRT for NPC. Methods A total of 20 patients with T_1-2 NPC who were treated from 2013 to 2015 were enrolled, and LCNs were delineated on CT images. Target volume delineation and treatment plan designing were performed according to the method recommended by RTOG0225(RTOG target volume delineation method) or the Chinese Working Committee for Clinical Staging of NPC in 2010(Chinese target volume delineation method), and the differences in the dose to LCNs and NTCP were calculated. Results In the RTOG and Chinese Methods for target volume delineation, D_max to the left and right LCNs was 7450±273 cGy/7294±309 cGy and 7361±160 cGy/7190±395 cGy, respectively (P=0.018 and 0.042), D_mean was 6735±285 cGy/6660±333 cGy and 6446±429 cGy/6299±467 cGy, respectively (both P=0.000), and the NTCP was 60%±10%/57%±13% and 51%±15%/45%±17%, respectively (both P=0.000). Conclusions It is feasible to precisely delineate target volume with the LCNs as a routine OAR and predict NTCP in IMRT for T_1-2 NPC. The NTCP of the LCNs is closely associated with target volume dose and irradiated volume. The dose to the LCNs and NTCP determined by the Chinese target volume delineation method are significantly lower than those determined by the RTOG method.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Qian Jianjun
	Sun Yanze
	Zhou Gang
	Tian Ye
	Lu Xueguan

Key words： Nasopharynx neoplasms/intensity modulated radiotherapy Lower cranial nerves Normal tissue complication probability

Received: 23 October 2015

Corresponding Authors: Lu Xueguan,Email:luxueguan@163.com

Cite this article:

Qian Jianjun,Sun Yanze,Zhou Gang et al. Difference in normal tissue complication probability of lower cranial nerves between target volumes recommended by Radiation Therapy Oncology Group and China in intensity-modulated radiotherapy for T_1-2 nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 546-551.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.06.002 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I6/546

[1] Mourad WF,Young BM,Young R,et al. Clinical validation and applications for CT-based atlas for contouring the lower cranial nerves for head and neck cancer radiation therapy[J].Oral Oncol,2013,49(9):956-963.DOI:10.1016/j.oraloncology.2013.03.449.
[2] Lee NY,Harris J,Garden A,et al. Phase Ⅱ multi-institutional study of IMRT ± chemotherapy for nasopharyngeal Int J Radiat Oncol Biol Phys,2007,69(S3):S13-14. carcinoma (RTOG 0225):preliminary results[J].DOI:10.1016/j.ijrobp.2007.07.025.
[3] Lee NY,Zhang Q,Pfister DG,et al. Addition of bevacizumab to standard chemoradiation for locoregionally advanced nasopharyngeal carcinoma (RTOG 0615):a phase 2 multi-institutional trial[J].Lancet Oncol,2012,13(2):172-180.DOI:10.1016/S1470-2045(11)70303-5.
[4] 中国鼻咽癌临床分期工作委员会.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001.Committee on clinical staging of nasopharyngeal carcinoma in China. Expert consensus on target area and dose design guidelines for 2010 nasopharyngeal carcinoma patients with radiotherapy[J]Chin J Radiat Oncol,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001.
[5] Lin SJ,Pan JJ,Han L,et al. Nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy:report on the 3-year outcome of a prospective series[J].Int J Radiat Oncol Biol Phys,2009,75(4):1071-1078.DOI:10.1016/j.ijrobp.2008.12.015.
[6] 潘建基,韩露,张瑜,等.鼻咽癌缩小临床靶体积调强放疗疗效探讨[J].中华放射肿瘤学杂志,2010,19(4):283-287.DOI:10.3760/cma.j.issn.1004-4221.2010.04.001.
Pan JJ,Han L,Zhang Y,et al. Impact of reducing clinical target volume on efficacy of intensity modulated radiation therapy for nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2010,19(4):283-287.DOI:10.3760/cma.j.issn.1004-4221.2010.04.001.
[7] Webb S,Nahum AE.A model for calculating tumour control probability in radiotherapy including the effects of inhomogeneous distributions of dose and clonogenic cell density[J].Phys Med Biol,1993,38(6):653-666.DOI:10.1088/0031-9155/38/6/001.
[8] Burman C,Kutcher GJ,Emami B,Goiten M.Fitting of normal tissue tolerance data to an analytic function[J].Int J Radiat Oncol Biol Phys,1991,21(1):123-135.DOI:10.1016/0360-3016(91)90172-Z.
[9] Lyman JT,Wolbarst AB.Optimization of radiation therapy,Ⅲ:a method of assessing complication probabilities from dose-volume histograms[J].Int J Radiat Oncol Biol Phys,1987,13(1):103-109.DOI:10.1016/0360-3016(87)90266-5.
[10] Emami B,Lyman J,Brown A,et al. Tolerance of normal tissue to therapeutic irradiation[J].Int J Radiat Oncol Biol Phys,1991,21(1):109-122.DOI:10.1016/0360-3016(91)90171-Y.
[11] 潘建基,洪金省,张瑜.鼻咽癌常规放疗后组颅神经的剂量学研究[J].福建医科大学学报,2006,40(2):132-135.DOI:10.3969/j.issn.1672-4194.2006.02.010.
Pan JJ,Hong JS,Zhang Y.Dosimetric study of lower cranial nerve after conventional radiotherapy in patients with nasopharyngeal carcinoma[J].J Fujian Med Univ,2006,40(2):132-135.DOI:10.3969/j.issn.1672-4194.2006.02.010.
[12] Kutcher GJ,Burman C,Brewster L,et al. Histogram reduction method for calculating complication probabilities for three-dimensional treatment planning evaluations[J].Int J Radiat Oncol Biol Phys,1991,21(1):137-146.DOI:10.1016/0360-3016(91)90173-2.
[13] Kong L,Lu JJ,Liss AL,et al. Radiation-induced cranial nerve palsy:a cross-sectional study of nasopharyngeal cancer patients after definitive radiotherapy[J].Int J Radiat Oncol Biol Phys,2011,79(5):1421-1427.DOI:10.1016/j.ijrobp.2010.01.002.
[14] Rong X,Tang Y,Chen M,et al. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma[J].Strahlenther Onkol,2012,188(3):282-286.DOI:10.1007/s00066-011-0047-2.
[15] Bakst RL,Lee N,Pfister DG,et al. Hypofractionated dose-painting intensity modulated radiation therapy with chemotherapy for nasopharyngeal carcinoma:a prospective trial[J].Int J Radiat Oncol Biol Phys,2011,80(1):148-153.DOI:10.1016/j.ijrobp.2010.01.026.
[16] Luk YS,Shum JSF,Sze HCK,et al. Predictive factors and radiological features of radiation-induced cranial nerve palsy in patients with nasopharyngeal carcinoma following radical radiotherapy[J].Oral Oncol,2013,49(1):49-54.DOI:10.1016/j.oraloncology.2012.07.011.
[17] Lin YS,Jen YM,Lin JC,et al. Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma[J].Cancer,2002,95(2):404-409.DOI:10.1002/cncr.10668.
[18] King AD,Leung SF,Teo P,et al. Hypoglossal nerve palsy in nasopharyngeal carcinoma[J].Head Neck,1999,21(7):614-619.DOI:10.1002/(SICI)1097-0347(199910)21:7<614::AID-HED5>3.0.CO;2-I.
[19] 孔琳,张有望,吴永如,等.鼻咽癌放射治疗后颅神经损伤影响因素研究[J].中华放射肿瘤学杂志,2005,14(1):10-14.DOI:10.3760/j.issn:1004-4221.2005.01.003.
Kong L,Zhang YW,Wu YR,et al. Radiation-induced cranial nerve palsy and its causative factors in nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2005,14(1):10-14.DOI:10.3760/j.issn:1004-4221.2005.01.003.
[20] 林少俊,潘建基,韩露,等.鼻咽癌小靶区调强放疗及化疗的远期疗效分析[J].中华放射肿瘤学杂志,2013,22(5):378-382.DOI:10.3760/cma.j.issn.1004-4221.2013.05.011.
Lin SJ,Pan JJ,Han L,et al. Long-term outcome of nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiotherapy and chemotherapy[J].Chin J Radiat Oncol,2013,22(5):378-382.DOI:10.3760/cma.j.issn.1004-4221.2013.05.011.
[21] Wu SG,Huang SJ,Zhou J,et al. Dosimetric analysis of the brachial plexus among patients with breast cancer treated with post-mastectomy radiotherapy to the ipsilateral supraclavicular area:report of 3 cases of radiation-induced brachial plexus neuropathy[J].Radiat Oncol,2014,9(1):292.DOI:10.1186/s13014-014-0292-5.
[22] 魏宝清.从鼻咽癌放疗后颅神经放射损伤探讨当前放疗技术上的问题[J].中华放射肿瘤学杂志,1994,3(3):164-168,217.Wei BQ.Radiation induced cranial neuropathy (RICN) after radiotherapy for nasopharyngeal carcinoma (NPC):Cause related to radiation technique[J].Chin J Radiat Oncol,1994,3(3):164-168,217.