摘要
目的观察调强适形放射治疗(intensity-modulated radiation therapy,IMRT)治疗Ⅰ、Ⅱ期鼻咽癌(nasopharyngeal carcinoma,NPC)患者的长期随访结果、分析预后相关影响因素及不良反应。方法回顾性分析2005年6月至2015年12月接受IMRT治疗的210例T1-2N0-1期NPC患者,其中Ⅰ期35例(16.7%)、Ⅱ期175例(83.3%)。Ⅱ期中113例(64.6%)接受了放化疗,余行单纯放疗。鼻咽和区域淋巴结肿瘤靶区剂量为66 Gy/30次。结果中位随访时间91个月,5年、10年生存率分别是97.1%、87.8%。5年、10年局部控制率、区域淋巴结控制率和无远处转移率分别是95.7%、92.8%,98.6%、98.6%和96.2%、94.1%。Ⅱ期113例化疗组和未化疗组的5年、10年生存率、区域淋巴结控制率、无远处转移率差异均无统计学意义(P=0.535,0.942,0.754)。放化疗组的局部控制率比单纯放疗组高(P=0.009)。无4度晚期反应,3度晚期反应发生率低,主要是听力下降、龋齿、口干,放射性颅神经损伤和颞叶损伤的发生率为1.4%和3.3%。第2肿瘤发生率为6.7%。结论接受IMRT治疗的Ⅰ、Ⅱ期NPC患者在局部、区域控制率、无远处转移率和生存率方面均有明显获益,不良反应低。Ⅱ期患者加用化疗未提高生存率。
Objective To observe the long-term follow-up results of intensity-modulated radiation therapy(IMRT)in patients with stageⅠ-Ⅱnasopharyngeal carcinoma(NPC)and analyze the related prognostic factors and adverse reactions.Methods A retrospective analysis was conducted from Jun 2005 to Dec 2015 in 210 NPC patients with T1-2N0-1 disease treated with IMRT.Among them,35 patients(16.7%)were stageⅠand 175 patients(83.3%)were stageⅡ.Of stageⅡpatients,113 patients(64.6%)received chemoradiotherapy and the rest received radiotherapy alone.The primary dose was 66 Gy/30Fx.Results The median follow-up time was 91 months,and the 5-and 10-year overall survival rates(OS)were 97.1%and 87.8%,respectively.The 5-and 10-year local control rates(LC),regional control rates(RC)and distant metastasis-free survival rates(DMFS)were 95.7%and 92.8%,98.6%and 98.6%,96.2%and 94.1%,respectively.There were no differences in 5-and 10-year OS,RC and DMFS between stageⅡpatients with or without(P=0.535,0.942,0.754).The LC of chemoradiotherapy group was higher than that of radiotherapy alone group(P=0.009).There were no grade 4 late toxicities,and the incidence of grade 3 late toxicities were rare,mainly including hearing loss,dental caries,dry mouth.And incidence of cranial nerve injury and temporal lobe injury was 1.4%and 3.3%,respectively.The incidence of the second tumor was 6.7%.Conclusion StageⅠ-ⅡNPC patients treated with IMRT can achieve high LC,RC,DMFS,OS and low adverse reactions.The addition of chemotherapy in stageⅡpatients did not improve survival.
作者
殷欢
薛芬
何霞云
孟晓燕
YIN Huan;XUE Fen;HE Xia-yun;MENG Xiao-yan(Department of Radiation Oncology,Shanghai Cancer Center,Fudan University,Shanghai 200032,China;Department of Oncology,Shanghai Medical College,Shanghai 200032,China;Shanghai Key Laboratory of Radiation Oncology,Shanghai 200032,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2022年第4期542-547,共6页
Fudan University Journal of Medical Sciences
基金
上海市科委扬帆计划(21YF1408400)
上海市科委科技创新行动计划(21Y11911900)
复旦大学附属肿瘤医院院级基金(YJQN202023)。
关键词
鼻咽癌(NPC)
早期
调强适形放射治疗(IMRT)
化疗
不良反应
nasopharyngeal carcinoma(NPC),early stage
intensity-modulated radiation therapy(IMRT)
chemotherapy
adverse reactions
