老年局部晚期鼻咽癌诱导化疗联合放疗与单纯放疗的配对研究  

Matched study comparing induction chemotherapy followed by radiation therapy with radiotherapy alone for advanced nasopharyngeal carcinoma in the elderly

作　　者：曾奇[1,2] 向燕群[2] 姚蔚[1] 吕星[2] 陈秋燕[2] 张海波[2] 郭翔[2] 

机构地区：[1]中山大学附属第五医院放疗科,广东珠海519000 [2]中山大学肿瘤防治中心鼻咽科华南肿瘤学国家重点实验室,广东广州510060

出　　处：《中华肿瘤防治杂志》2013年第7期518-521,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨诱导化疗在老年局部晚期鼻咽癌中的疗效及毒副作用。方法:选取接受2个周期PF诱导化疗联合放疗的老年局部晚期鼻咽癌患者61例作为研究对象,以性别、年龄、病理类型、治疗开始时间、T与N分期、鼻咽部放疗剂量、颈部放疗剂量、放疗时间作为配对条件,与接受单纯放疗的老年患者1∶1配对,进行生存情况和毒副作用分析,比较组间差异。结果:联合放化组和单纯放疗组5年总生存率分别为65.0%和40.0%,P=0.012。肿瘤相关生存率分别为71.0%和43.0%,P=0.010。无瘤生存率分别为67.0%和48.0%,P=0.027。无复发生存率分别为88.0%和70.0%,P=0.019。无远处转移生存率分别为75.0%和68.0%,P=0.279。联合放化疗组血液毒性大于单纯放疗组(P<0.05),两组Ⅲ级毒性发生率分别为52.5%和31.1%,P=0.017。结论:诱导化疗联合放疗能提高局部晚期老年鼻咽癌患者总生存率、肿瘤相关生存率、无瘤生存率及无复发生存率,未能降低无远处转移生存率;Ⅲ级黏膜炎发生率明显偏高。OBJECTIVE： To evaluate the effect and toxicity of induction chemotherapy followed by radiation therapy in elderly patients with advanced nasopharyngeal carcinoma （NPC）. METHODS： Totally 61 elderly patients with advanced NPC received induction chemotherapy （DDP＋5-FU） for 2 cycles followed by definitive radiation therapy （CRT group）. These patients were matched with the reference group who received radiotherapy alone （RT group）. Matching characteristics were gender,age,histological type, start time of treatment, T and N stages, radiotherapy dose to primary tumor and neck nodes,days of radiotherapy. The count data were compared using the chi-square test;the survival rate was calculated by Life tables. Kaplan-Meier method was used for survival analysis. The difference among survival curves was compared by log-rank test. RESULTS：The 5-year overall survival rates （OS） were 65.0% and 40.0% （P=0. 012）. The cancer-specific survival rates （CSS） were 71.0%0 and 43.0% （P=0. 010）. The failure-free survival rates （FFS） were 67.0o/60 and 48.0% （P=0. 027）. The locoregional failure-free survival rates （LR-FFS） were 88.0% and 70.0% （P=0. 019）. The distant failure-free survival rates （D-FFS） for the CRT and RT groups were 75.0% and 68.0% （P=0. 279）. The CRT group experienced significantly more acute haematological toxicity （P〈0.05）. The incidence of grade Ⅲ mucositis was obviously higher in CRT group （52. 5% vs 31. 1%, P= 0. 017）. CONCLUSION： This matched study shows induction chemotherapy followed by radiation therapy improves OS,CSS,FFS and LR-FFS in elderly patients with advanced NPC, but not in D-FFS with increasing grade Ⅲ mucositis.

关 键 词：鼻咽肿瘤 老年人 诱导化疗 放疗 配对分析 

分 类 号：R739.63[医药卫生—肿瘤]