3~4周期NACT对N<sub>2</sub>—N<sub>3</sub>期鼻咽癌临床价值分析

doi:10.3760/cma.j.issn.1004-4221.2017.04.003

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摘要

目的探讨3~4周期新辅助化疗(NACT)对N₂—N₃期鼻咽癌预后的影响。方法回顾分析2007—2010年间915例T_1-4N_2-3M₀期鼻咽癌患者资料。以行3~4周期NACT者为观察组(NACT≥3组),行2周期NACT (NACT=2组)和未行NACT (NACT=0组,即同期放化疗组)作为对照组。按1:2:1比例以年龄、N分期、病理类型、NACT方案配对后,NACT≥3组、NACT=2组、NACT=0组分别有179、358、179例纳入生存分析。Kaplan-Meier法计算OS、DFS、RFS、DMFS,Logrank法检验和单因素分析,Cox模型多因素分析。结果 NACT≥3组、NACT=2组、NACT=0组5年OS分别为89.4%、81.6%、73.7%(P=0.000),5年DFS分别为83.2%、69.8%、64.2%(P=0.000),5年RFS分别为86.0%、76.0%、69.3%(P=0.001),5年DMFS分别为86.6%、76.0%、68.3%(P=0.000)。3~4周期NACT是N₂—N₃期鼻咽癌OS、DFS、RFS、DMFS的保护因素(P=0.000、0.001、0.001、0.000)。结论 3~4周期NACT能显著改善N₂—N₃期鼻咽癌预后。

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	魏嘉旺
	黄蓉
	余昕
	王俏镟
	肖巍魏
	卢丽霞
	高远红
	常晖

关键词 ：鼻咽肿瘤/新辅助化疗, 预后

Abstract：

Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N₂-N₃ nasopharyngeal carcinoma (NPC). Methods The clinical data of 915 patients with T_1-4N_2-3M₀ NPC from 2007 to 2010 were retrospectively analyzed. A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT=0 group, concurrent chemoradiotherapy group) for age, N stage, pathological subtype, and NACT regimen. The Kaplan-Meier method was used to calculate overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS) rates, the log-rank test was used for survival difference analysis and univariate prognostic analysis, and the Cox proportional hazards model was used for multivariate prognostic analysis. Results For the NACT≥3, NACT=2, and NACT=0 groups, the 5-year OS rates were 89.4%, 81.6%, and 73.7%, respectively (P=0.000), the 5-year DFS rates were 83.2%, 69.8%, and 64.2%, respectively (P=0.000), the 5-year RFS rates were 86.0%, 76.0%, and 69.3%, respectively (P=0.001), and the 5-year DMFS rates were 86.6%, 76.0%, and 68.3%, respectively (P=0.000). Three to four cycles of NACT was an independent protective factor for OS, DFS, RFS, and DMFS in patients with N₂-N₃ NPC. Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N₂-N₃ NPC.

Key words： Nasopharyngeal neoplasms/neoadjuvent chemotherapy Prognosis

收稿日期: 2016-09-01

基金资助:

中山大学5010研究项目(2015022)

通讯作者: 高远红,Email:gaoyh@sysucc.org.cn;常晖,Email:changhui@sysucc.org.cn

引用本文:

魏嘉旺,黄蓉,余昕等. 3~4周期NACT对N₂—N₃期鼻咽癌临床价值分析[J]. 中华放射肿瘤学杂志, 2017, 26(4): 380-383.

Wei Jiawang,Huang Rong,Yu Xin et al. Impact of three to four cycles of neoadjuvant chemotherapy on survival of patients with N₂-N₃ nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(4): 380-383.

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