局部中晚期鼻咽癌诱导化疗后放疗开始时间与预后相关  

Correlation between the waiting time for radiotherapy and prognosis after induction chemotherapy for locally intermediate and advanced nasopharyngeal carcinoma

作　　者：李光烈 徐西伟[1] 王思阳[1] Li Guanglie;Xu Xiwei;Wang Siyang(Department of Head and Neck Oncology,The Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院头颈部肿瘤科,珠海519000

出　　处：《中华放射肿瘤学杂志》2023年第12期1037-1043,共7页Chinese Journal of Radiation Oncology

摘　　要：目的探讨局部中晚期鼻咽癌诱导化疗后放疗开始时间与预后之间的关系及其最佳开始时间。方法回顾性分析2017-2020年中山大学附属第五医院收治的局部中晚期鼻咽癌患者101例, 所有患者接受了至少2个疗程的诱导化疗后行根治性放疗。放疗等待时间定义为诱导化疗结束至第1次放疗开始所等待的时间。通过Cox回归分析法明确放疗等待时间以及其他因素(年龄、性别、分期等)与预后指标包括无进展生存(PFS)、无局部复发生存(LRFS)、无远处转移生存(DMFS)之间的关系。以中位放疗等待时间3周作为界限, 所有患者被分成≤3周和>3周两组, 通过Kaplan-Meier生存分析法比较两组的PFS、LRFS、DMFS。P<0.05为差异有统计学意义。结果 Cox回归分析发现, 放疗等待时间与PFS、LRFS、DMFS相关(P<0.05)。生存分析发现, 放疗等待时间≤3周组的PFS、LRFS、DMFS明显优于>3周组(P<0.05)。同样在T_(3)期、N_(2)期和治疗前EB病毒DNA复制水平升高的情况下, 放疗等待时间≤3周组的PFS、LRFS、DMFS均优于>3周组(P<0.05)。结论放疗等待时间是影响局部中晚期鼻咽部患者预后的因素之一。诱导化疗后放疗开始时间越早预后越好, 最好控制在3周以内。Objective To investigate the correlation between the waiting time for radiotherapy after induction chemotherapy and the prognosis of locally intermediate and advanced nasopharyngeal carcinoma,as well as its optimal time.Methods Retrospective analysis of 101 patients with locally intermediate and advanced nasopharyngeal carcinoma admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from 2017 to 2020 was performed.All patients received at least 2 courses of induction chemotherapy followed by radical radiotherapy.The waiting time for radiotherapy was defined as the time from the end of induction chemotherapy to the start of the first radiotherapy.The relationship between waiting time for radiotherapy and other factors(age,gender and stage,etc.)with progression-free survival(PFS),local recurrence-free survival(LRFS)and distant metastasis-free survival(DMFS)was analyzed through Cox model.The median waiting time for radiotherapy with 3 weeks was used as the boundary,and all patients were divided into≤3 weeks and>3 weeks groups.The PFS,LRFS and DMFS between two groups were compared using Kaplan-Meier survival analysis.P<0.05 was considered as statistical significance.Results Cox-regression analysis showed that the waiting time was correlated with PFS,LRFS,and DMFS(all P<0.05).Kaplan-Meier survival analysis suggested that the PFS,LRFS and DMFS in the≤3 weeks group were significantly better than those in the>3 weeks group(all P<0.05).Under the premises of the T,stage,N,stage and the increased EB virus DNA replication levels before treatment,the PFS,LRFS and DMFS in the≤3 weeks group were significantly better than those in the>3 weeks group(all P<0.05).Conclusions The waiting time for radiotherapy is one of the factors affecting clinical prognosis of locally intermediate and advanced nasopharyngeal carcinoma.The earlier the time,the better the prognosis.Radiotherapy should be delivered within 3 weeks.

关 键 词：鼻咽肿瘤 局部中晚期 诱导化学疗法 放射疗法等待时间 预后 

分 类 号：R739.63[医药卫生—肿瘤]