Abstract：
This systematic review examines the role of dosimetric parameters in predicting temporal lobe necrosis (TLN) risk in nasopharyngeal carcinoma (NPC) patients treated with three-dimensional conformal RT (3D-CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). TLN is a serious late complication that can adversely affect the quality of life of NPC patients. Understanding the relationship between dosimetric parameters and TLN can guide treatment planning and minimize radiation-related complications. A comprehensive search identified relevant studies published up to July 2023. Studies reporting on dosimetric parameters and TLN in NPC patients undergoing 3D-CRT, IMRT, and VMAT were included. TLN incidence, follow-up duration, and correlation with dosimetric parameters of the temporal lobe were analyzed. The review included 30 studies with median follow-up durations ranging from 28 to 110 months. The crude incidence of TLN varied from 2.3 % to 47.3 % and the average crude incidence of TLN is approximately 14 %. Dmax and D1cc emerged as potential predictors of TLN in 3D-CRT and IMRT-treated NPC patients. Threshold values of >72 Gy for Dmax and >62 Gy for D1cc were associated with increased TLN risk. However, other factors should also be considered, including host characteristics, tumor-specific features and therapeutic factors. In conclusion, this systematic review highlights the significance of dosimetric parameters, particularly Dmax and D1cc, in predicting TLN risk in NPC patients undergoing 3D-CRT, IMRT, and VMAT. The findings provide valuable insights that can help in developing optimal treatment planning strategies and contribute to the development of clinical guidelines in this field.
摘要：
这项系统评价研究了剂量学参数在预测接受三维适形RT（3D-CRT）治疗的鼻咽癌（NPC）患者颞叶坏死（TLN）风险中的作用。强度调制放射治疗（IMRT）和体积调制电弧治疗（VMAT）。TLN是一种严重的晚期并发症，可对NPC患者的生活质量产生不利影响。了解剂量学参数与TLN之间的关系可以指导治疗计划并最大程度地减少与辐射相关的并发症。一项全面的搜索确定了截至2023年7月发表的相关研究。关于接受3D-CRT的NPC患者的剂量学参数和TLN的研究报告，IMRT,包括VMAT。TLN发生率,随访持续时间,并与颞叶剂量学参数进行相关性分析。该综述包括30项研究，中位随访时间为28至110个月。TLN的粗发生率从2.3％到47.3％不等，TLN的平均粗发生率约为14％。在3D-CRT和IMRT治疗的NPC患者中，Dmax和D1cc是TLN的潜在预测因子。Dmax>72Gy和D1cc>62Gy的阈值与TLN风险增加相关。然而,还应该考虑其他因素，包括主机特征，肿瘤特异性特征和治疗因素。总之,这篇系统的综述强调了剂量学参数的重要性，特别是Dmax和D1cc，在预测接受3D-CRT的NPC患者的TLN风险中，IMRT,和VMAT。这些发现提供了有价值的见解，可以帮助制定最佳的治疗计划策略，并有助于该领域临床指南的制定。
