中国西北地区早期鼻咽癌调强放疗联合化疗的临床研究  

Intensity-modulated radiotherapy combined with chemotherapy for early-stage nasopharyngeal carcinoma patients in northwest China

作　　者：罗山泉[1] 石梅[1] 王建华[1] 许曼[1] 周彬[1] 肖锋[1] 

机构地区：[1]第四军医大学西京医院放疗科,西安710032

出　　处：《中华放射肿瘤学杂志》2012年第4期302-305,共4页Chinese Journal of Radiation Oncology

摘　　要：目的分析生长在西北地区的早期鼻咽癌（T1-2N0-1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T1N0-1、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％（X2=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％（X2=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％（x2=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（）（2=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。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 T1NO _ 1, T2 No and T2 N1 stage were 100% , 100%, 100% and 74%, 81% , 87% ,respectively （X2 =5.74,P =0. 01 ;X2 =4. 95 ,P =0.03 ;X2 =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 （ X2 = 4. 02, P = 0. 04 ; X2 = 4. 12, P = 0. 03 ; X2 = 4. 84,P =0. 02）. In T2Nl stage, IMRT combined with chemotherapy and IMRT alone were 100% ,100% , 100% and 79% ,79% ,80% respectively （ X2 = 5.28,P = 0. 03 ; X2 = 4. 84,P = 0. 04 ; X2 = 4. 72,P = 0. 04）. In univariate analysis, N stage, clinical stage, IMRT combined with chemotherapy were significantly associated with the survival （ X2 = 5.39, P = 0. 02 ; X2 = 5.74, P = 0. 01 ; X2 = 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.

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 

分 类 号：R739.63[医药卫生—肿瘤]