选择鼻癌患者接受适应性放射治疗的战略
Heleen Bollen1,2, Elena Onorati3, Annouschka Laenen4
1Laboratory of Experimental Radiotherapy, Department of Oncology, University of Leuven, Leuven, Belgium.
Frontiers in oncology
|October 15, 2025
概括
鼻癌 (NPC) 患者的适应性放射治疗 (ART) 可以通过在治疗前确定特定的临床标准来优化. 这种方法有助于选择患者,并确定在放射治疗 (RT) 期间重新规划的最佳时间.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 在瘤学瘤学.
背景情况:
- 鼻癌 (NPC) 患者在放射治疗 (RT) 期间经历了显著的解剖变化.
- 适应性放射治疗 (ART) 需要在治疗期间重新计划,需要明确的患者选择和时间协议.
- 目前的方法缺乏治疗前的患者选择标准和ART实施的最佳时间.
研究的目的:
- 开发一种预治疗方法,用于选择符合ART条件的NPC患者.
- 在放射治疗过程中确定启动ART的最佳时间.
主要方法:
- 在2016年至2023年期间治疗的47名NPC患者的回顾性分析.
- 使用CT和CBCT扫描对腺,气腔,鼻和身体轮进行体积测量评估.
- 关于生存结果的卡普兰-梅尔分析和体积变化的线性混合模型;预测截止值的识别.
主要成果:
- 两年和五年地方区域控制率为95%,总生存率为100%和93%.
- 观察到显著的腺体和身体轮体积减少,特别是在RT的3-4周之间.
- 已识别的体积减少预测因素包括结节疾病,初始鼻体积,BMI,N阶段,RT剂量和原发性瘤CTV.
结论:
- 建议在分数15和20之间重新评估RT计划.
- 选择ART的治疗前标准包括N3阶段,重的淋巴结 (>15mm),BMI (>28),乳腺剂量 (>31 Gy),乳腺体积 (>56cc),CTV (>93cc) 和缺乏诱导化疗.
- 对这些预测因素的前性验证对于临床实施至关重要.
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