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鼻咽癌IMRT后局部与区域失败模式研究
孔芳芳,应红梅,黄爽,杜承润,周珺珺,陈俊超,陈晓慧,孙力宁,胡超苏
200032 上海,复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院放疗科
Patterns of local-regional failure after intensity-modulated radiotherapy for nasopharyngeal carcinoma
Kong Fangfang,Ying Hongmei,Huang Shuang,Du Chengrun,Zhou Junjun,Chen Junchao,Chen Xiaohui,Sun Lining,Hu Chaosu
Department of Radiation Oncology,Fudan University Shanghai Cancer Center;Department of Oncology,ShanghaiMedical College,Fudan University,Shanghai 200032,ChinaYing Hongmei,Email:yinghongmei2013@163.com
Abstract：Objective To investigate the dosimetric patterns of local-regional failure after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC), and to provide a clinical basis for further improvement in the therapeutic effect for NPC. Methods The patterns of local-regional failure in 364 previously untreated NPC patients without distant metastasis who were admitted to our hospital from December 2007 to April 2012 were analyzed. The failures were classified as “in-field failure” if Vrecur within the 95% isodose curve (V95%) was ≥95%, “marginal failure” if V95% was less than 95% and not less than 20%, or “out-field failure” if V95% was<20%. The Kaplan-Meier method was used to calculate survival rates. Results The median follow-up was 40 months (range 3-84 months). The 3-year local failure-free survival, regional failure-free survival, distant metastasis-free survival, overall survival, and progression-free survival were 94.1%, 95.4%, 86.5%, 90.9%, and 78.7%, respectively. A total of 35 patients experienced local-regional recurrence, and in-field recurrence, marginal recurrence, and out-field failure accounted for 81.1%, 8.1%, and 10.8%, respectively. Conclusions In-field failures are the main dosimetric patterns of local-regional recurrence after IMRT for NPC, suggesting that radiation resistance of tumor cells is an important reason for local-regional failure.
Kong Fangfang,Ying Hongmei,Huang Shuang et al. Patterns of local-regional failure after intensity-modulated radiotherapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 95-99.
2016, Vol. 25 
