Nazofarenks kanserinde kemoradyoterapi
Chemoradiotherapy in nasopharyngeal carcinaoma
Yazar: METEHAN KARACA
Danışman: PROF. DR. CENGİZ KURTMAN
Ankara Üniversitesi / Tıp Fakültesi / Radyasyon Onkolojisi Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2008
Konu: Radyoloji ve Nükleer Tıp = Radiology and Nuclear Medicine

Özet:
Between 1986 and 2004, 110 NPC patients who had been treated by curativeintend were analysed retrospectively. The patients were divided into two groups toreceive RT alone (56 patients) and Cisplatin based CRT (54 patients). The medianOS, LC, NC and SC values for the groups were found to be 94, 62, 168 and 192months respectively on the analysis time (March 2007). No statistical difference wasfound between the two groups considering the OS, LC, NC and SC values. The Tand overall stages were found to affect the OS, LC and NC values and failure ratiosindependent of the treatment modality. It was also found that the patient age isanother prognostic factor which affects the OS and LC durations and failure ratiosbeing independent of the treatment modality. A correlation was found between thelocal and/or nodal failures and mortality. However, the systemic metastasesprobabilty was shown to be independent of the treatment success or failure onprimary site.Although it has increased due to the use of chemotherapy, the toxicity level isfound to be significantly lower than the values reported in the literature. This can beexplained by the concurrent use of Cisplatin doses with RT, the methodologicalapproach of the study and the follow-up conditions. Based on the result of our studyand the literature, it is concluded that using Cisplatin at a weekly dose of 20 or30mg/m2 is an applicable and tolerable way of treatment. However, it is observedthat compared to the success rates obtained with a weekly dose of 40mg/m2, theCisplatin doses used in our study do not make a contribution to the OS, LC, NC andSC rates.Keywords: Nasopharyngeal Carcinoma, Radiotherapy, Chemoradiothreapy.

Abstract:
1986-2004 yillan arasmda bolvimumiizde kuratif amacla tedavi gormvis 110NFK hastasi geriye doniik olarak incelendi. Hastalar, RT (56 vaka) ve KRT (54vaka) olmak iizere iki gruba ayrildi. Analiz tarihi olan Mart 2007'de hastalannortanca GS, LK, NK ve SK degerleri sirasiyla 94, 62, 168 ve 192 ay olarak bulundu.Iki grup arasmda GS, LK, NK, SK olasiliklarmda kullandigimiz Cisplatin tabanheszamanh protokollerinin istatistik acidan anlamh bir farkhhk yaratmadigi goriildvi.Ancak, tedavi seklinden bagimsiz bicimde genel evre ve T evresinin GS, LK ve NKdegerlerini etkiledigi bulundu. Hasta yasmm da GS ve LK degerleri ve basansizligietkileyen bir diger prognostik faktor oldugu goriildvi. Lokal ve/veya nodalbasansizhklar ile olgunun hayatmi kaybetmesi arasmda bir iliski oldugu bulundu.Ancak sistemik metaztaz olasihgmm, tedavinin primer hastalrktaki basan ya dabasansizligmdan bagimsiz oldugu goriildvi.Incelememize gore KT kullammiyla artmis olsa bile mevcut toksisitelerinliteratiir verilerine oranla belirgin diizeyde az olmasi, kullamlan RT'ye eszamanhCisplatin dozlan, cahsmanm metodolojik bifimi ve izlem kosullanyla a?iklanabilir.Bununla birlikte literatiir verileri ve ?alismamizm sonuflarma dayamlarak agirhkholarak kullandigimiz haftahk 20 veya 30mg/m2 Cisplatin dozunun genel olarakuygulanabilir ve hastalar tarafmdan tolere edilebilir bir tedavi sekli oldugu goriildvi.Ancak, Cisplatin dozunun haftahk 40mg/m2 olarak verilmesi ile elde edilen basanoranlanyla karsilastinldigmda cahsmamizda kullamlmis olan dozlarm GS, LK, NKve SK oranlan vizerine bir katkisi olmadigi goriildvi.Anahtar Kelimeler: Nazofarenks Karsinomu, Radyoterapi, Kemoradyoterapi.