鼻咽癌调强放射治疗后局部与区域复发模式  

Patterns of local or regional recurrence after intensity-modulated radiotherapy for nasopharyngeal carcinoma

作　　者：李博[1] 康敏[1] 陆颖 于斌[3] 廖雪银 宾颖 周平婷 杨振东 刘康 李吉茜 王仁生[1] Li Bo;Kang Min;Lu Ying;Yu Bin;Liao Xueyin;Bin Ying;Zhou Pingting;Yang Zhendong;Liu Kang;Li Jixi;Wang Rensheng(Department of Radiation Oneology,First Affiliated Hospital of Guangxi Medical University/Guangxi Clinical Medicine Research Center for Radiation Oncology,Nanning 530021 ,China;Department of Oncology,Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545000, China;Department of Radiation Oncology, Liuzhou General Hospital,Liuzhou 545000,China;Department of Radiation Oncology, People＇s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China)

机构地区：[1]广西医科大学第一附属医院放疗科广西肿瘤放射治疗临床医学研究中心,南宁530021 [2]柳州市工人医院肿瘤科,柳州545000 [3]柳州市人民医院放疗科,柳州545000 [4]广西壮族自治区人民医院放疗科,南宁530021

出　　处：《中国癌症防治杂志》2018年第2期124-128,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家自然科学基金资助项目(81460460;81760542;81360405);广西自然科学基金资助项目(2014GXNSFBA118114;2016GXNS FAA380252);中国博士后科学基金资助项目(2016M602918XB);广西医疗卫生适宜技术研究与开发课题资助项目(S201415-07)

摘　　要：目的探讨鼻咽癌患者接受调强放疗(intensity-modulated radiotherapy,IMRT)后的复发模式。方法回顾性分析2009年1月至2012年12月645例接受IMRT治疗、无远处转移的初治鼻咽癌患者的临床资料,Kaplan-Meier法计算生存率,并分析其复发模式,同时比较复发与未复发患者的剂量学差异。结果 645例患者中位随访62个月(11~95个月),其中复发(包括局部或区域复发)60例,单纯局部复发33例,区域复发23例,局部+区域复发4例。60例复发患者1年、3年、5年复发率分别为0.9%、6.5%、9.0%,总局部控制率分别为99.1%、93.4%、90.1%;野内复发56例,野边缘复发3例,野外复发1例;治疗结束后3年内49例患者复发。复发病例与未复发病例无剂量学差异。结论 IMRT治疗鼻咽癌局部控制率良好,复发最常见于治疗结束后3年内,男性多见,野内复发为局部与区域的主要复发模式。Objective The aim of this study was to evaluate patterns of local or regional recurrence of nasopharyngeal carcinoma （NPC） in patients treated with intensity-modulated radiotherapy（IMRT）. Methods We performed a retrospective analysis of 645 patients with NPC treated at three centers in China from January 2009 to December 2011. All patients had non-metastatic NPC that had not been treated prior to IMRT. The Kaplan-Meier method was used to calculate patient survival rates ,and log-rank testing was used to compare survival differences,and explore treatment failure patterns for local or regional recurrence after radiotherapy. Results During a mean follow-up of 62 months （11-95）,local recurrence rates were 0.9% at 1 year,6.5% at 3 years,and 9.0% at 5 years. Locoregional control rates were 99.1% at 1 year,93.4% at 3 years,and 90.1% at 5 years. In the 60 patients with recurrence,in-field recurrence rate was 93.3% （56/60）;marginal-field recurrence, 5.0% （3/60）;and out-field recurrence, 1.7% （1/60）. Of all treatment failures, 81.7% （49/60） occurred within the first three years after treatment. Condusions IMRT resulted in excellent locoregional control in our NPC patients. Most cases of recurrence happened in the first three years after treatment. Locoregional failure most often involved in-field recurrence.

关 键 词：鼻咽肿瘤 调强放射治疗 局部复发 区域复发 

分 类 号：R739.63[医药卫生—肿瘤]