跳至主要内容

Evaluation of Efficacy and Toxicity of Helical Tomotherapy in the Treatment of Patients with Nasal NK/T-Cell Lymphoma

Read  full  paper  at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53395#.VMCLACzQrzE

ABSTRACT
Purpose: Nasal lymphoma created dosimetric challenges in radiotherapy due to the complex anatomical structures. This study was to evaluate the efficacy and toxicity of helical Tomotherapy (HT) in the treatment of nasal NK/T-cell lymphoma (NKTCL) patients. Methods and Materials: Between August 2008 and April 2013, a total of 25 NKTCL patients were treated with HT in our department; Among them, three patients have not received chemotherapy, one patient has received concurrent chemo-radiation with CHOP plus L-ASP, two patients have received the sequential chemotherapy regimen following irradiation, and all the others have received 1 - 2 cycles of induction chemotherapy followed by irradiation and then with sequential chemotherapy. CHOP-L with 1 - 7 cycles (median: 4 cycles) was utilized as the main chemotherapy regimen. As for HT, the gross tumor volume (GTV) received target doses (TD) ranging from 50 to 56 Gy (median: 50 Gy) at 2 - 2.78 Gy per fraction; and the clinical target volume (CTV) from 36 to 50 Gy (median: 40 Gy) at 1.6 - 2 Gy per fraction. Results: For those patients who had received irradiation, thirteen achieved complete remission (CR), four partial responses (PR); four had progressive disease (PD), two were lost to follow-up, two died within one month after irradiation and were not followed. In 21 patients with follow-up records, the overall response (CR + PR) was 81.0% with the 3-year survival rate of 87.2%, and the mean survival time was 52.8 months [95% confidence interval (CI): 45.2 - 60.4 months]. After radiotherapy the majority of patients had dry mouth and taste changes in varying degrees, and a small portion of patients had compromised hearing or vision functions. No brain injury symptoms occurred during radiation radiotherapy. Conclusions: As compared with conventional three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy (IMRT) performed with HT, HT appears to have more favorable efficacy and toxicity profiles in the treatment of NKTCL. Further systematic and randomized clinical research is under investigation.
 
Cite this paper
Qu, B. , Zhao, X. , Meng, L. , Xu, S. , Xie, C. and Yang, J. (2015) Evaluation of Efficacy and Toxicity of Helical Tomotherapy in the Treatment of Patients with Nasal NK/T-Cell Lymphoma. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 4, 32-40. doi: 10.4236/ijmpcero.2015.41005.
 
References
[1]Aozasa, K., Takakuwa, T., Hongyo, T. and Yang, W. (2008) Nasal NK/T-Cell Lymphoma: Epidemiology and Pathogenesis. International Journal of Hematology, 87, 110-117.
http://dx.doi.org/10.1007/s12185-008-0021-7
 
[2]Yin, W., Yu, Z., Xu, F. and Hu, Y. (2008) Clinical Radiation Oncology. 4th Edition, China Union Medical University Press, Beijing, 754-764.
 
[3]Li Y., Liu, Q., Wang, W., Jin, J., Song, Y., Wang, S., Liu, Y., Zhou, L. and Yu, Z. (2011) Failure Patterns and Clinical Implications in Early Stage Nasal Natural Killer/T-Cell Lymphoma Treated with Primary Radiotherapy. Cancer, 117, 5203-5211. http://dx.doi.org/10.1002/cncr.26167
 
[4]Li, Y., Wang, H., Jin, J., Wang, W., Liu, Q., Song, Y., Wang, Z., Qi, S., Wang, S., Liu, Y. and Yu, Z. (2012) Radiotherapy Alone with Curative Intent in Patients with Stage I Extranodal Nasal-Type NK/T-Cell Lymphoma. International Journal of Radiation Oncology Biology Physics, 82, 1809-1815.
http://dx.doi.org/10.1016/j.ijrobp.2010.10.040
 
[5]Yong, Y., Zhang, Y. and Bin, L. (2009) Radiotherapy in Early Nasal Type NK/T Cells in Lymphoid Tumor Effect of the Combined Treatment and Prognosis. Chinese Journal of Radiation Oncology, 18, 285-289.
 
[6]Zheng, L., Ma, X., Wang, J., Xu, Q., Zhang, S. and Hu, J. (2013) IMRT with Conventional Radiotherapy in Early Stage Nasal NK/T-Cell Lymphoma Patients Treated Controls. China Oncology, 23, 229-234.
 
[7]Li, Y., Yao, B., Jin, J., Wang, W., Liu, Y., Song, Y., Wang, S., Liu, X., Zhou, L., He, X., Lu, N. and Yu, Z. (2006) Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma. Journal of Clinical Oncology, 24, 181-189. http://dx.doi.org/10.1200/JCO.2005.03.2573
 
[8]Ma, H., Qian, L., Pan, H., Yang, L., Zhang, H., Wang, Z., Ma, J., Zhao, Y., Gao, J. and Wu, A. (2010) Treatment Outcome of Radiotherapy Alone versus Radiochemotherapy in Early Stage Nasal Natural Killer/T-Cell Lymphoma. Medical Oncology, 27, 798-806.
http://dx.doi.org/10.1007/s12032-009-9288-7
 
[9]Xu, S., Wang, L., Dai, X., Huang, H. and Xie, C. (2008) Helical Tomotherapy System Theory and Its Application Principle and Application of Helical Tomotherapy. Chinese medical Equipment Journal, 29, 100-102.
 
[10]Cui, D., Dai, K., Ma, L., Xu, S., Wang, S., Xia, Z., Chun, F. and Lam, S. (2008) Nasopharyngeal Helical Tomotherapy IMRT and Conventional Accelerators Dosimetric Comparison: A Dosimetric Comparison between Helical Tomotherapy and Linear Accelerator-Based Intensity Modulated Radiation Therapy for Nasopharyngeal Carcinoma. Chinese Journal of Radiation Oncology, 5, 169-173.
 
[11]Tomita, N., Kodaira, T., Tachibana, H., Nakamura, T., Nakahara, R., Inokuchi, H., Mizoquchi, N. and Takada, A. (2009) A Comparison of Radiation Treatment Plans Using IMRT with Helical Tomotherapy and 3D Conformal Radiotherapy for Nasal Natural Killer/T-Cell Lymphoma. The British Journal of Radiology, 82, 756-763.
http://dx.doi.org/10.1259/bjr/83758373
 
[12]Gong, H., Xie, C. and Xu, S. (2011) Dosimetric Comparison between Helical Tomotherapy and Step-and-Shoot Intensity Modulated Radiation for Nasal T/NK-Cell Lymphoma. The Practical Journal of Cancer, 4, 377-380.
 
[13]Wu, R.J., Li, Y.X., Jin, J., Wang, S.L., Yue, P., Song, Y.W., Ren, H., Liu, Q.F., Wang, C.Y., Qi, S.N., Lu, N.N., Bo, E.P., Zhou, S. and Yu, Z.H. (2011) Webster Ring Primary Diffuse Large B-Cell and Extranodal Nasal Type NK Compare Clinical Features and Prognosis/T-Cell Lymphoma. Chinese Journal of Radiation Oncology, 20, 80-88.
 
[14]Kim, S., Kim, K., Kim, B., Kim, C., Suh, C., Huh, J., Lee, S., Kim, J., Cho, J., Lee, G., Kang, K., Eom, H., Pyo, H., Ahn, Y., Ko, Y. and Kim, W. (2009) Phase II Trial of Concurrent Radiation and Weekly Cisplatin Followed by VIPD Chemotherapy in Newly Diagnosed, Stage IE to IIE, Nasal, Extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma Study. Journal of Clinical Oncology, 27, 6027-6032.
http://dx.doi.org/10.1200/JCO.2009.23.8592
 
[15]Yamaguchi, M., Tobinai, K., Oguchi, M., Ishizuka, N., Kobayashi, Y., Isobe, Y., Ishizawa, K., Maseki, N., Toh, K., Usui, N., Wasada, I., Kinoshita, T., Ohshima, K., Matsuno, Y., Terauchi, T., Nawano, S., Ishikura, S., Kagami, Y., Hotta, T. and Oshimi, K. (2009) Phase I/II Study of Concurrent Chemoradiotherapy for Localized Nasal Natural Killer/ T-Cell Lymphoma: Japan Clinical Oncology Group Study JCOG0211. Journal of Clinical Oncology, 27, 5594-5600.
 
[16]Wang, H., Li, Y., Wang, W., Jin, J., Dai, J., Wang, S., Liu, Y., Song, Y., Wang, Z., Liu, Q., Fang, H., Qi, S., Liu, X. and Yu, Z. (2012) Mild Toxicity and Favorable Prognosis of High-Dose and Extended Involved-Field Intensity-Modulated Radiotherapy for Patients with Early-Stage Nasal NK/T-Cell Lymphoma. The British Journal of Radiology, 82, 1115-1121.
http://dx.doi.org/10.1016/j.ijrobp.2011.02.039                                                        eww150122lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文