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454例鼻咽癌IMRT±化疗远期疗效及影响因素分析
龙金华,金风,吴伟莉,李媛媛,陈潇潇,龚修云,麻发强,戚正君
550004 贵阳医学院附院肿瘤科贵州省肿瘤医院头颈肿瘤科
Long-term efficacy of intensity-modulated radiotherapy with or without chemotherapy in treatment of nasopharyngeal carcinoma and its influencing factors:an analysis of 454 patients
Long Jinhua,Jin Feng,Wu Weili,Li Yuanyuan,Chen Xiaoxiao,Gong Xiuyun,Ma Faqiang,Qi Zhengjun
Department of Head& Neck,Cancer Hospital of Guizhou Province,Guiyang 550005,China
Abstract：Objective To analyze the long-term efficacy of intensity-modulated radiotherapy (IMRT) with or without chemotherapy in treatment of 454 patients with nasopharyngeal carcinoma (NPC) and its influencing factors. Methods A retrospective analysis was performed on the clinical data of 454 patients with non-metastatic NPC who received IMRT with or without chemotherapy in our center from 2007 to 2012. Prescribed doses of 69.96-73.92 Gy in 33 fractions, 69.96 Gy in 33 fractions, 60.06 Gy in 33 fractions, and 50.96 Gy in 28 fractions were applied to nasopharyngeal gross tumor volume, cervical metastatic lymph nodes, high-risk drainage area, and low-risk drainage area, respectively. In all patients, 438 received induction chemotherapy, 420 concurrent chemotherapy, and 216 adjuvant chemotherapy, most of which were based on cisplatin and taxol. The Kaplan-Meier method was used for calculating survival rates and the log-rank test was used for survival difference analysis and univariate prognostic analysis. The Cox model was used for the multivariate prognostic analysis. Results The 3-year sample size was 210. The 3-year overall survival (OS), local recurrence-free survival, nodal relapse-free survival, progression-free survival, and distant metastasis-free survival (DMFS) rates were 88.1%, 91.0%, 90.7%, 80.5%, and 85.1%, respectively. Age, T stage, and N stage were influencing factors for the OS rate (P=0.011;P=0.005;P=0.033);T stage and N stage were influencing factors for the disease progression-free survival (P=0.017;P=0.005) and DMFS (P=0.012;P=0.019). The grade ≥3 acute and late adverse reactionsincluded hematological toxicity, oral mucositis, xerostomia, dysphagia, and brain injury. Conclusions IMRT promotes the long-term survival rates in patients with NPC. The distant metastasis is the major reason for treatment failure. The adverse reactions induced by IMRT combined with chemotherapy are tolerable.
Long Jinhua,Jin Feng,Wu Weili et al. Long-term efficacy of intensity-modulated radiotherapy with or without chemotherapy in treatment of nasopharyngeal carcinoma and its influencing factors:an analysis of 454 patients[J]. Chinese Journal of Radiation Oncology, 2015, 24(6): 659-661.
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2015, Vol. 24 
