中国西北地区早期鼻咽癌调强放疗联合化疗的临床研究

doi:10.3760/cma.j.issn.1004-4221.2012.04.003

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摘要目的分析生长在西北地区的早期鼻咽癌(T_1~2N_0~1期)患者调强放疗联合化疗的疗效及预后因素。方法回顾分析2006—2009年本院收治的 58例早期鼻咽癌患者临床资料。Kaplan-Meier法计算生存率,并Logrank法检验和单因素分析。结果随访率100%,随访满2、3年者分别为50、46例。全组1、2、3年生存率分别为98%、94%、91%。分层分析显示T₁N_0~1、T₂N₀期与T₂N₁期 3年总生存率、局部无复发生存率、无远处转移生存率不同,分别为100%和74%、100%和81%、100%和87%(χ²=5.74、4.95、4.24,P=0.01、0.03、0.04);全组放化疗与单纯放疗的不同,分别为100%与85%、100%与85%、100%与88%(χ²=4.02、4.12、4.84,P=0.04、0.03、0.02);T₂N₁期中放化疗与单纯放疗的也不同,分别为100%与79%、100%与79%、100%与80%(χ²=5.28、4.84、4.72,P=0.03、0.04、0.04)。单因素分析显示N分期、临床分期、放化疗与生存相关(χ²=5.39、5.74、4.02,P=0.02、0.01、0.04)。结论早期鼻咽癌各亚组中T₂N₁期是远处转移的高危亚组,调强放疗联合化疗可能提高该组病例的无复发生存率、无远处转移生存率及总生存率。

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	罗山泉
	石梅
	王建华
	许曼
	周彬
	肖锋

关键词 ：中国西北地区鼻咽肿瘤, 鼻咽肿瘤/调强放射疗法, 鼻咽肿瘤//化学疗法, 预后

Abstract：Objective To evaluate the therapeutic efficacy and prognostic factors of intensity-modulated radiotherapy combined with chemotherapy for early-stage nasopharyngeal carcinoma patients in northwest China. Methods From January 2006 to December 2009, 58 patients with early-stage nasopharyngeal carcinoma were treated with IMRT in Xijing hospital, the clinical data were analyzed retrospectively. Survival rates was calculated by the Kaplan-Meier method and the differences was compared by the Logrank test. Univariate analysis method was use to identify all significant factors. Results The follow-up rate was 100%. The follow-up time of 46 patients was more than 3 years. The 1-, 2 and 3-year survival were 98%, 94% and 91%, respectively. The 3-year overall survival (OS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) for T₁N_0－1,T₂N₀ and T₂N₁ stage were 100%, 100%, 100% and 74%, 81%, 87%,respectively (χ²=5.74,P=0.01;χ²=4.95,P=0.03;χ²=4.24,P=0.04). The 3-year OS, LRFS, DMFS for IMRT combined with chemotherapy and IMRT alone were 100%,100%, 100% and 85%,85%,88% respectively (χ²=4.02,P=0.04;χ²=4.12,P=0.03;χ²=4.84,P=0.02). In T₂N₁ stage, IMRT combined with chemotherapy and IMRT alone were 100%,100%, 100% and 79%,79%,80% respectively (χ²=5.28,P=0.03;χ²=4.84,P=0.04;χ²=4.72,P=0.04).In univariate analysis, N stage, clinical stage, IMRT combined with chemotherapy were significantly associated with the survival (χ²=5.39,P=0.02;χ²=5.74,P=0.01;χ²=4.02,P=0.04). Conclusions
In all early-stage nasopharyngeal carcinoma, T₂N₁ stage is a sub-group of high risk of distant metastasis. Combination of IMRT and chemotherapy may improve the LRFS, DMFS and OS in those patients.

Key words： Nasopharyngeal neoplasms in northwest China Nasopharyngeal neoplasms/ intensity-modulated radiotherapy Nasopharyngeal neoplasms/chemotherapy Prognosis

收稿日期: 2011-10-09

引用本文:

罗山泉,石梅,王建华等. 中国西北地区早期鼻咽癌调强放疗联合化疗的临床研究[J]. 中华放射肿瘤学杂志, 2012, 21(4): 302-305.

LUO Shan-quan,SHI Mei,WANG Jian-hua et al. Intensity-modulated radiotherapy combined with chemotherapy for early-stage nasopharyngeal carcinoma patients in northwest China[J]. Chinese Journal of Radiation Oncology, 2012, 21(4): 302-305.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2012.04.003 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2012/V21/I4/302

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