在头部和部状细胞癌中使用DWI指导的DP-IMRT和基于传统的MRI的IMRT:一项比较研究
Chao Tan1,2, Yuyi Li1,2, Cuihong Jiang1
1The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, Changsha, Hunan, China.
BMC cancer
|August 23, 2025
概括
用扩散权重成像 (DWI) 引导的剂量绘制强度调节的放射治疗改善了头部和部状细胞癌患者的无疾病生存率. 这种先进的技术在不增加急性不良事件的情况下提高了结果.
科学领域:
- 辐射瘤学
- 癌症学
- 医学成像
背景情况:
- 头部和部状细胞癌 (HNSCC) 的治疗是复杂的.
- 在HNSCC中扩散权重成像 (DWI) 导向剂量绘制强度调节辐射疗法 (DP-IMRT) 的作用尚不清楚.
- 将DWI引导的DP-IMRT与基于传统的MRI的IMRT进行比较对于优化治疗策略至关重要.
研究的目的:
- 在HNSCC患者中比较DWI引导的DP-IMRT与基于MRI的标准IMRT的疗效和毒性.
- 评估醉酒导致的剂量升级对生存率和复发率的影响.
- 确定影响HNSCC治疗结果的预后因素.
主要方法:
- 在2018年6月至2022年11月期间治疗的260名HNSCC患者的回顾性分析.
- 两个组:126名DWI组 (77 Gy/35 fx到GTV) 和134名标准组 (70 Gy/35 fx到GTV) 的患者.
- 所有患者都接受了诱导化疗;使用多变量分析来比较生存率和毒性.
主要成果:
- 酒精饮酒指导的DP- IMRT显著改善了两年无病生存率 (75. 2% vs. 63. 8%,P=. 011) 和局部无复发生存率 (75. 9% vs. 64. 7%,P=. 013).
- 整体存活率在各组之间没有显著差异 (P=.442).
- 3-5级的毒性是可比的;以DWI为指导的剂量绘制是DFS的独立预后因素 (HR0. 559,P=0. 037).
结论:
- 在HNSCC患者中,以DWI为指导的剂量升级为无疾病生存提供了显著的好处.
- 这种方法不会导致急性不良事件的增加.
- 酒后驾驶的DP-IMRT代表了HNSCC治疗的有希望的进步,改善了无复发的生存率.
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