69例局部复发鼻咽癌调强放疗疗效及预后分析  

Intensity-modulated radiotherapy for 69 locally recurrent nasopharyngeal carcinoma cases:analysis of efficacy and prognostic factors

作　　者：吴婷婷[1] 马礼钦[2] 邱素芳[2] 张瑜[2] 潘建基[1,2] 杨凌[2] 林少俊[2] 

机构地区：[1]福建医科大学研究生教育学院,福州350014 [2]福建省肿瘤医院放疗科

出　　处：《中国癌症防治杂志》2012年第3期233-237,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

摘　　要：目的回顾性分析局部复发鼻咽癌调强放疗的疗效及影响预后的相关因素。方法 69例局部复发鼻咽癌患者均行调强放疗,再程放疗pGTV总剂量为49.5～77.4Gy(中位剂量为66Gy),每次分割剂量1.86～2.5Gy(中位2.1Gy)。48例接受1～6个周期以铂类为基础的化疗。结果全组患者的中位随访时间为20个月,截止末次随访日期,死亡24例(34.8%)。1、2年局部无进展生存率、无远处转移生存率及总生存率分别为92.9%、81.8%、81.8%和88.8%、65.5%、65.5%。单因素分析结果显示,首程放疗方式(P=0.004)和再程放疗总剂量(P=0.011)与生存期相关;多因素分析发现影响局部复发鼻咽癌的独立预后因素有首程放疗方式(P=0.004)和再程放疗总剂量(P=0.004)。放疗期间的急性毒副反应均可耐受。结论 IMRT是局部复发鼻咽癌的有效治疗手段,可提高患者的生存率。首程放疗方式和再程放疗总剂量是影响患者生存时间的独立预后因素。Objective To examine retrospectively the efficacy and prognostic factors of locally recurrent nasopharyngeal carcinoma （NPC） treated with intensity-modulated radiotherapy （IMRT）. Methods Sixty nine locally recurrent NPC patients were performed IMRT,the second irradiation total prescription dose was 49.5-77.4Gy （median fractional dose 66Gy）,and fractional dose was 1.86- 2.SGy （median fractional dose 2.1Gy）.Forty eight patients were treated with 1-6 courses of cisplatin-based chemotherapy. Results The median follow-up time was 20 months.The rates of 1-year local progression-free survival,distant metastasis-free survival, and overall survival were 92.9%,81.8% and 81.8%,respectively.The rates of 2-year local progression-free survival, distant metastasis-free survival, and overall survival were 88.8%, 65.5% and 65.5%, respectively. The result of univariate analysis showed that both the first RT modality（P=0.004） and the second irradiation dose （P=0.011 ） were positively related to the survival time, respectively.The result of multivariate analysis showed that both the first RT modality（P=0.004） and the second irradia-tion dose（P=0.004） influenced the prognosis of recurrent NPC ＂after radiotherapy.The toxicity response during radiotherapy was well tolerated in patients. Conclusion IMRT is effective to locally recurrent NPC and can improve survival rate.Both the first RT modality and the second irradiation dose are independent prognostic factors of the overall survival for locally recurrent NPC patients.

关 键 词：鼻咽肿瘤 局部复发 调强放射治疗 预后 

分 类 号：R739.63[医药卫生—肿瘤]