临床肿瘤学杂志

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635例非高发区局部晚期鼻咽癌调强放疗的长期随访观察

王婷婷,宋丹,吴俚蓉1,尹丽,黄生富,何侠   

  1. 江苏省肿瘤医院放疗科
  • 收稿日期:2016-08-13 修回日期:2016-09-17 出版日期:2016-11-30 发布日期:2016-11-30
  • 通讯作者: 吴俚蓉

The long-term survival outcomes of 635 patients with locoregionally advanced nasopharyngeal carcinoma treated with intensitymodulated radiation therapy in non endemic area

WANG Tingting, SONG Dan, WU Lirong, YIN Li, HUANG Shengfu, HE Xia.   

  1. Department of Radiation Oncology, Jiangsu Cancer Hospital
  • Received:2016-08-13 Revised:2016-09-17 Online:2016-11-30 Published:2016-11-30
  • Contact: WU Lirong

摘要: 目的 探讨江苏省初治局部晚期(Ⅲ、ⅣA、ⅣB期)鼻咽癌患者调强放疗联合化疗治疗后长期生存情况及预后影响因素。方法 收集江苏省肿瘤医院放疗科2009年1月至2013年12月收治的局部晚期鼻咽癌635例进行回顾性分析。所有患者均接受调强放疗,其中604例患者接受了含铂方案为主的化疗。采用Kaplan-Meier法进行生存分析,用Log-rank检验和Cox比例风险回归模型分析局部晚期鼻咽癌患者的预后相关因素。结果 随访5~92个月,中位随访时间63.5个月。全组患者的5年局部无复发生存(LRFS)、 区域无复发生存(RRFS)、无远处转移生存(DMFS)、无进展生存(DFS)、总生存(OS)率分别为88.4%、94.2%、79.2%、71.9%和76.3%。175例(27.6%)治疗失败,其中远处转移(131例,74.9%)是主要的治疗失败形式。T分期是LRFS的独立预后因素,临床分期、N分期和化疗是RRFS、DMFS、DFS及OS的独立预后因素。结论 调强放疗提高了鼻咽癌患者的远期疗效。除了T、N分期是影响预后的重要因素外,化疗对预后也起到一定的作用。

Abstract: Objective To evaluate the longterm survival outcomes and prognostic factors of locoregionally advanced (Ⅲ, ⅣA, ⅣB) nasopharyngeal carcinoma(NPC) patients treated with intensitymodulated radiation therapy (IMRT) plus chemotherapy in Jiangsu Province. Methods From January 2009 to December 2013, 635 locoregionally advanced NPC patients treated by IMRT and platinumbased chemotherapy were analyzed retrospectively. Survival data were calculated with a KaplanMeier method. Logrank test and Cox proportional hazard regression model were performed to investigate the risk factors of prognosis. Results With a median follow-up of 63.5 months (range 5.92 months), the 5-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasisfree survival (DMFS), diseasefree survival (DFS) and overall survival (OS) rates were 88.4%, 94.2%, 79.2%, 71.9% and 76.3%, respectively. Of the 635 patients, 175 (276%) developed failure after treatment. Distant metastasis (n=131, 749%) was the major failure pattern after treatment. T stage was an independent prognostic factor for LRFS. N stage, clinical stage and chemotherapy were independent prognostic factors for RRFS, DMFS, DFS and OS. Conclusion IMRT provides satisfactory longterm outcome for NPC. T and N stage are important prognostic factors, as well as chemotherapy.

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