The change trend of late complications in patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy: the clinician-and patient-reported outcomes
10.3760/cma.j.issn.1004-4221.2018.08.002
- VernacularTitle: 鼻咽癌IMRT后长期存活者晚期损伤及其变化趋势——患者评价和医生评价结果
- Author:
Ye ZHANG
1
;
Xiaodong HUANG
;
Li GAO
;
Guozhen XU
;
Jianping XIAO
;
Jingwei LUO
;
Shiping ZHANG
;
Kai WANG
;
Yuan QU
;
Junlin YI
Author Information
1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal neoplasms/intensity-modulated radiotherapy;
Radiation-induced injury;
Evaluation
- From:
Chinese Journal of Radiation Oncology
2018;27(8):721-726
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the change trend of late complications of patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) after 5-year follow up according to the clinician-and patient-reported outcomes.
Methods:From 2014 to 2015, NPC patients surviving> 5 years after radical IMRT at our outpatients department and were followed up 3 years later. The late complications were evaluated by the clinician based upon the CTCAE 4.0 rating criteria and assessed by patients themselves into 5 grades including very good, good, fair, poor and very poor.
Results:A total of 116 NPC patients were included in the first survey with a median follow-up time of 6.5 years (range, 5.0-11.3 years). During the second survey, 21 patients were lost to follow-up, 7 patients developed nasopharyngeal recurrence or metastases, 7 patients had second primary tumors and 81 patients were eligible for final analysis. In the first survey, the most common clinician-reported ≥grade 2 late complications were subcutaneous fibrosis (n=17, 21.0%) and hearing impairment (n=13, 16.0%). The most frequent patient-reported "poor" and "very poor" late complications included dental caries (n=27, 33.3%), subcutaneous fibrosis (n=17, 21.0%) and hearing impairment (n=12, 14.8%). During the second survey, the most common complications were aggravated or new late complications occurred including hearing impairment (n=16, 20.0%), dental caries (n=16, 20.0%) and posterior cranial neuropathy (n=9, 11.0%).
Conclusions:The incidence of late complications is high after radical IMRT for NPC. During the long-term survival, subcutaneous fibrosis and hearing impairment are the main late complications. The incidence of hearing impairment, dental caries and posterior cranial neuropathy is increased over time. The symptoms of hearing impairment and dental caries are aggravated in partial patients.
