Yıl: 2021 Cilt: 35 Sayı: 3 Sayfa Aralığı: 291 - 300 Metin Dili: Türkçe DOI: 10.5505/deutfd.2021.32748 İndeks Tarihi: 15-05-2022

İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler

Öz:
Amaç: Yerel ve/veya bölgesel yineleme sonrası ikinci seri radyoterapi (İSRT) uygulanan nazofarenks kanserli hastalardaki tedavi sonuçlarımızı retrospektif olarak irdelemektir. Gereç ve Yöntem: 1991 ve 2018 yılları arasında nazofarenks kanseri için definitif radyoterapi ± kemoterapi aldıktan sonra lokal ve/veya bölgesel yineleme saptanan 44 hastadan 27’sine ikinci seri radyoterapi uygulanmış ve çalışmaya dahil edilmiştir. Bulgular: İlk tedavi sonrası medyan takip 49 (13-255) aydır. Primer radyoterapi sonrası yinelemeye kadar geçen süre medyan 18 ay (3-216) olup, 20 (%74) hastada yerel, 5 (%19) hastada bölgesel ve 2 (%7,4) lokal ve bölgesel yineleme saptanmıştır. İSRT, 16 (%59) hastaya konvansiyonel, 5 (%18) hastaya konformal, 4(%11) hastaya VMAT ve 2(%7) hastaya Stereotaksik Radyoterapi tekniği kullanılarak, medyan 30 (4-35) fraksiyon ve 2 Gy (2-7) fraksiyon dozu ile medyan toplam doz 60 Gy (15-70) olacak şekilde uygulanmıştır. RT sonrası yanıt değerlendirmede; 7 (%26) tam yanıt, 11 (%41) kısmi yanıt ve 9 (%33) hastada progresyon saptanmıştır. İki-5 yıllık genel sağ kalım oranları sırasıyla %85-%47, yineleme sonrası ise %44-%24’dür. İSRT sonrası 2 ve 5 yıllık progresyonsuz sağ kalım oranları ise %34 ve %20’dir. Tek değişkenli analizde; genel sağkalım için, yinelemeye kadar geçen süre (p< 0,001), ISRT doz (p=0,048); PSK’da ise, ISRT tekniği (p= 0,01), yenilemeye kadar geçen süre (p<0,001), ISRT doz (p=0,002) anlamlı olarak saptanmıştır. Çok değişkenli analizde sadece yinelemeye kadar geçen süre (p<0,001) istatistiksel anlamlı bulunmuştur. Sonuç: Sınırlı sayıda hasta olmasına rağmen sağkalım oranları tatmin edici bulunmuştur. Gelecekte teknolojik gelişmelerin de yardımıyla bu tür yüksek riskli hastalıklarda daha az yan etki ile daha iyi sağkalım oranları elde edilebilecektir.
Anahtar Kelime:

TREATMENT RESULTS AND PROGNOSTIC FACTORS FOR NASOPHARYNGEAL CARCINOMA AFTER RE-IRRADIATION

Öz:
Intrduction: To investigate the treatment results of re-irradiation for local and/or regional relapse of nasopharyngeal cancer. Methods: There were forty four patients between 1991 and 2018 who recurred locally and/or regionally after receiving definitive radiation ± chemotherapy for nasopharyngeal cancer. Twenty-seven of them received reirradiation and were recruited in our study. Results: Median follow-up period after the first treatment was 49 (13-255) months. Twenty patients (74%) locally, 5 (19%) regionally, and 2 tumors (7.4%) recurred both locally and regionally recurrence. Seven (26%) had complete, 11 (41%) had partial, and 9 (33%) patients had progressive response after re-irradiation. Overall survival for 2 and 5 years was 85% and 47% from the first treatment and 44% and %24 from recurrence. 2 and 5 years were 34% and 20%, respectively. Univariate analyses for overall survival showed statistical significance for interval between first treatment and recurrence (p< 0.001) and re-irradiation dose (p=0.048) while it was re-irradiation technique (p= 0.01), interval between first treatment and recurrence (p<0.001) and reirradiation dose (p=0.002) for progression-free survival. Time to recurrence (p<0.001) was found to be statistically significant at multivariate analysis. Conclusion: Survival rates are found to be satisfying despite the limited number of patients. Better survival rates with less adverse effects at such high-risk organs involving area are going to be gained by the help of technological developments in the future.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Cetinayak H, ŞENGÜL A, SEMİZ V, ÇAKIR A, Karabay N, ALICIKUŞ Z, TEKER M, AKMAN F (2021). İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. , 291 - 300. 10.5505/deutfd.2021.32748
Chicago Cetinayak Hasan Oguz,ŞENGÜL Adem,SEMİZ Volkan,ÇAKIR Aslı,Karabay Nuri,ALICIKUŞ Zümre ARICAN,TEKER Merve,AKMAN Fadime İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. (2021): 291 - 300. 10.5505/deutfd.2021.32748
MLA Cetinayak Hasan Oguz,ŞENGÜL Adem,SEMİZ Volkan,ÇAKIR Aslı,Karabay Nuri,ALICIKUŞ Zümre ARICAN,TEKER Merve,AKMAN Fadime İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. , 2021, ss.291 - 300. 10.5505/deutfd.2021.32748
AMA Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. . 2021; 291 - 300. 10.5505/deutfd.2021.32748
Vancouver Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. . 2021; 291 - 300. 10.5505/deutfd.2021.32748
IEEE Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F "İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler." , ss.291 - 300, 2021. 10.5505/deutfd.2021.32748
ISNAD Cetinayak, Hasan Oguz vd. "İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler". (2021), 291-300. https://doi.org/10.5505/deutfd.2021.32748
APA Cetinayak H, ŞENGÜL A, SEMİZ V, ÇAKIR A, Karabay N, ALICIKUŞ Z, TEKER M, AKMAN F (2021). İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 35(3), 291 - 300. 10.5505/deutfd.2021.32748
Chicago Cetinayak Hasan Oguz,ŞENGÜL Adem,SEMİZ Volkan,ÇAKIR Aslı,Karabay Nuri,ALICIKUŞ Zümre ARICAN,TEKER Merve,AKMAN Fadime İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi 35, no.3 (2021): 291 - 300. 10.5505/deutfd.2021.32748
MLA Cetinayak Hasan Oguz,ŞENGÜL Adem,SEMİZ Volkan,ÇAKIR Aslı,Karabay Nuri,ALICIKUŞ Zümre ARICAN,TEKER Merve,AKMAN Fadime İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, vol.35, no.3, 2021, ss.291 - 300. 10.5505/deutfd.2021.32748
AMA Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2021; 35(3): 291 - 300. 10.5505/deutfd.2021.32748
Vancouver Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2021; 35(3): 291 - 300. 10.5505/deutfd.2021.32748
IEEE Cetinayak H,ŞENGÜL A,SEMİZ V,ÇAKIR A,Karabay N,ALICIKUŞ Z,TEKER M,AKMAN F "İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler." Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 35, ss.291 - 300, 2021. 10.5505/deutfd.2021.32748
ISNAD Cetinayak, Hasan Oguz vd. "İkinci Seri Radyoterapi Uygulanan Nazofarenks Kanserli Hastalarda Tedavi Sonuçlarımız ve Prognostik Faktörler". Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi 35/3 (2021), 291-300. https://doi.org/10.5505/deutfd.2021.32748