T1-2N1M0期鼻咽癌IMRT同期化疗疗效分析

doi:10.3760/cma.j.issn.1004-4221.2015.05.013

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摘要目的回顾性成组配对分析早期鼻咽癌单纯IMRT与IMRT同期化疗疗效及不良反应。方法 2009—2010年共98例T_1-2N₁M₀期鼻咽癌患者行单纯放疗或同期放化疗,筛选出39对患者进行疗效及不良反应对比分析。Kaplan-Meier法计算生存率且Logrank法检验。结果 3年随访率为95%。单纯IMRT组和同期放化疗组3年OS率分别为97%、95%(P=0.411),PFS率分别为97%、92%(P=0.301),LRFS率分别为97%、97%(P=0.606),DMFS率分别为100%、92%(P=0.082)。白细胞减少、贫血、血小板减少发生率同期放化疗组大于单纯IMRT组(P=0.000、0.000、0.000),单纯IMRT组与同期放化疗组3级口腔口咽黏膜炎发生率分别为26%和36%(P=0.093),听力下降发生率分别为41%、62%(P=0.100)。结论同期化疗联合IMRT未能提高早期鼻咽癌T_1-2N₁期患者OS、PFS、LRFS率,亦未能降低DMFS率;且血液毒性、3级黏膜炎、听力下降发生率较单纯IMRT组高。

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	江少娜
	李飞
	谢丽
	窦圣金
	朱国培
	胡超苏

关键词 ：鼻咽肿瘤/调强放射疗法, 鼻咽肿瘤/同期化学疗法, 预后

Abstract：Objective To retrospectively analyze the efficacy and toxicity of intensity-modulated radiotherapy (IMRT) alone and IMRT with concurrent chemotherapy (CRT) in the treatment of early-stage nasopharyngeal carcinoma (NPC) using pairwise group comparison. Methods A total of 98 patients with stage T_1-2N₁M₀ NPC were treated with IMRT alone or CRT from 2009 to 2010, and 39 pairs out of them were selected for comparison of efficacy and toxicity. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. Results The 3-year follow-up rate was 95%. There were no significant differences in the 3-year overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) rates between the IMRT alone group and the CRT group (97% vs. 95%, P=0.411;97% vs. 92%, P=0.301;97% vs. 97%, P=0.606;100% vs. 92%, P=0.082). The incidence rates of leucopenia, anemia, and thrombocytopenia were significantly higher in the CRT group than in the IMRT alone group (P=0.000;P=0.000;P=0.000). There were no significant differences in the incidence rates of grade 3 oral mucositis and hearing loss between the IMRT alone group and the CRT group (26% vs. 23%, P=0.093;41% vs. 62%, P=0.100). Conclusions CRT fails to increase the OS, PFS, and LRFS rates and reduce the DMFS rate in patients with stage T_1-2N₁ NPC. Moreover, CRT results in higher incidence rates of hematotoxicity, grade 3 mucositis, and hearing loss than IMRT alone.

Key words： Nasopharyngeal neoplasms/intensity-modulated radiotherapy Nasopharyngeal neoplasms/concurrent chemoradiotherapy Prognosis

基金资助:山东省医药卫生科技发展计划项目(2013WS0346)

通讯作者: 朱国培,E-mail:antica@gmail.com

引用本文:

江少娜,李飞,谢丽等. T_1-2N₁M₀期鼻咽癌IMRT同期化疗疗效分析[J]. 中华放射肿瘤学杂志, 2015, 24(5): 529-531.

Jiang Shaona^*,Li Fei,Xie Li et al. An analysis of efficacy of intensity-modulated radiotherapy with concurrent chemotherapy for stage T_1-2N₁ nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 529-531.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2015.05.013 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2015/V24/I5/529

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