Nazofarengeal Karsinom Tedavisinde Yoğunluk Ayarlı Radyoterapi ile Kombine Kemoterapinin Akut Yan Etkileri

Year 2023, Volume: 2 Issue: 4, 1 - 6, 30.12.2023

Mustafa Kandaz Atalay Balsak Kaan Aydoğdu Hatice Bengü Çobanoğlu

https://doi.org/10.59518/farabimedj.1323840

Abstract

Nazofarenks kanseri çok yaygın bir baş ve boyun kanseridir. Kemoradyoterapide eş zamanlı kemoterapi hastalığın kontrolünde önemli rol oynamasına rağmen tümörün anatomik yerleşimi nedeniyle akut toksisite riski yüksektir. Çalışmamızın amacı definitif kemoradyoterapi uygulanan nazofaringeal karsinom hastalarında görülen akut yan etkilerin değerlendirilmesidir. Nazofaringeal kanser tanısı alan ve tedavi gören 20-82 yaş aralığında toplam 64 (41 erkek, 23 kadın) hasta çalışmaya dahil edildi. Tüm hastalara yoğunluk ayarlı radyoterapi ile birlikte eşzamanlı kemoradyoterapi uygulandı. Tümör ve pozitif lenf nodlarına 70 Gy radyoterapi uygulanırken, tüm nazofarenks ve iki taraflı boyun lenf nodlarına 60 Gy radyoterapi uygulandı. Tedavi için üç kür sisplatin 100 mg/m2 (1., 22. ve 43. günler) veya haftalık 40 mg/m2 sisplatin kemoterapisi kullanıldı. Hastaların akut yan etkileri not edildi ve değerlendirildi. Çalışmaya dahil edilen hastaların 15'i (%23) evre II, 37'si (%58) evre III, 12'si (%19) ise evre IV hastalığa sahipti. Erkek hastalarda 2. ve 3. derece hematolojik toksisite oranları sırasıyla %47 ve %20 şeklindeydi. Kadın hastalarda 2. ve 3. derece hematolojik toksisite oranları sırasıyla %53 ve %80 tespit edildi. Her iki grup arasında hematolojik toksisite oranında anlamlı fark bulundu (p= 0.0001). 65 yaş altı hastalarda 2. ve 3. derece hematolojik toksisite oranları sırasıyla %47 ve %20 belirlendi. 65 yaş üstü hastalarda 2. derece ve 3. derece özofajit oranları sırasıyla %53 ve %80 idi. Her iki grup arasında özofajit oranında anlamlı fark görüldü (p= 0.0001). Elde ettiğimiz sonuçlar akut yan etkiler açısından literatürle uyumludur. Akut yan etkilerin sıkı takibi ve tedavisi, hastanın tedaviye uyumunu artırabilir, yaşam kalitesini iyileştirebilir ve tedavinin etkinliğini artırabilir.

Keywords

Nazofarengeal Karsinom, Kemoradyoterapi, Akut yan etki

Project Number

2017-77

Acute Side Effects of Combined Chemotherapy with Intensity-Modulated Radiotherapy in The Treatment of Nasopharyngeal Carcinoma

Abstract

Nasopharyngeal cancer is a very common head and neck cancer. Although concurrent chemotherapy plays an important role in controlling the disease, the risk of acute toxicity is high due to the anatomical location of the tumor. The aim of our study is to evaluate the acute side effects observed in nasopharyngeal carcinoma patients who underwent definitive chemoradiotherapy. A total of 64 patients (41 men, 23 women) between the ages of 20 and 82, who were diagnosed with nasopharyngeal cancer and treated, were included in the study. All patients received concurrent chemoradiotherapy along with intensity-modulated radiotherapy. While 70 Gy radiotherapy was applied to the tumor and positive lymph nodes, 60 Gy radiotherapy was applied to the entire nasopharynx and bilateral neck lymph nodes. Three cycles of cisplatin 100 mg/m2 (days 1, 22 and 43) or weekly 40 mg/m2 cisplatin chemotherapy were used for treatment. Acute side effects of the patients were noted and evaluated. Of the patients included in the study, 15 (23%) had stage II disease, 37 (58%) had stage III disease, and 12 (19%) had stage IV disease. The rates of grade 2 and 3 hematological toxicity in male patients were 47% and 20%, respectively. The rates of grade 2 and 3 hematological toxicity in male patients were 47% and 20%, respectively. A significant difference was found in the hematological toxicity rate between both groups (p= 0.0001). In patients under the age of 65, grade 2 and 3 hematological toxicity rates were determined as 47% and 20%, respectively. In patients over 65 years of age, the rates of grade 2 and 3 esophagitis were 53% and 80%, respectively. There was a significant difference in the rate of esophagitis between both groups (p= 0.0001). Our results are compatible with the literature in terms of acute side effects. Close monitoring and treatment of acute side effects can improve patient compliance with treatment, improve quality of life, and increase the effectiveness of treatment.

Keywords

Nasopharyngeal cancer, chemoradiotherapy, acute side effect

Project Number

2017-77

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