中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2011年
3期
181-185
,共5页
许婷婷%胡超苏%王孝深%吴永如%何霞云%应红梅
許婷婷%鬍超囌%王孝深%吳永如%何霞雲%應紅梅
허정정%호초소%왕효심%오영여%하하운%응홍매
鼻咽肿瘤/放化疗法%放化疗法,同期%放射疗法,常规分割%预后
鼻嚥腫瘤/放化療法%放化療法,同期%放射療法,常規分割%預後
비인종류/방화요법%방화요법,동기%방사요법,상규분할%예후
Nasopharyngeal neoplasms/radiochemotherapy%Radiochemotherapy,concurrent%Radiotherapy,conventional fmctionation%Prognosis
目的 评价放化疗中不同方式化疗对N3期鼻咽癌患者预后的影响.方法 回顾分析114例N3期鼻咽癌患者资料.9例接受单纯放疗;105例接受以铂类为基础化疗联合放疗,其中同期放化疗37例,诱导化疗+同期放化疗53例,同期放化疗+辅助化疗15例.鼻咽原发灶采用60Co γ线、6 MV X线常规分割照射70 Gy,颈部根治量60～68 Gy,颈部预防量54～60 Gy.结果 中位随访时间54个月,共51例患者死亡.全组5年总生存率为59.1%.单纯放疗、同期放化疗、诱导化疗+同期放化疗、同期放化疗+辅助化疗的5年总生存率分别为17%、51%、68%、71%(X2=15.44,P=0.001),无复发生存率分别为83%、77%、88%、93%(X2=2.34,P:0.505),无转移生存率分别为17%、54%、72%、80%(X2=19.28,P=0.000).结论 诱导化疗+同期放化疗及同期放化疗+辅助化疗方式对N3期鼻咽癌患者比单纯同期放化疗更具优势,最有效治疗方式有待随机研究证实.
目的 評價放化療中不同方式化療對N3期鼻嚥癌患者預後的影響.方法 迴顧分析114例N3期鼻嚥癌患者資料.9例接受單純放療;105例接受以鉑類為基礎化療聯閤放療,其中同期放化療37例,誘導化療+同期放化療53例,同期放化療+輔助化療15例.鼻嚥原髮竈採用60Co γ線、6 MV X線常規分割照射70 Gy,頸部根治量60～68 Gy,頸部預防量54～60 Gy.結果 中位隨訪時間54箇月,共51例患者死亡.全組5年總生存率為59.1%.單純放療、同期放化療、誘導化療+同期放化療、同期放化療+輔助化療的5年總生存率分彆為17%、51%、68%、71%(X2=15.44,P=0.001),無複髮生存率分彆為83%、77%、88%、93%(X2=2.34,P:0.505),無轉移生存率分彆為17%、54%、72%、80%(X2=19.28,P=0.000).結論 誘導化療+同期放化療及同期放化療+輔助化療方式對N3期鼻嚥癌患者比單純同期放化療更具優勢,最有效治療方式有待隨機研究證實.
목적 평개방화료중불동방식화료대N3기비인암환자예후적영향.방법 회고분석114례N3기비인암환자자료.9례접수단순방료;105례접수이박류위기출화료연합방료,기중동기방화료37례,유도화료+동기방화료53례,동기방화료+보조화료15례.비인원발조채용60Co γ선、6 MV X선상규분할조사70 Gy,경부근치량60～68 Gy,경부예방량54～60 Gy.결과 중위수방시간54개월,공51례환자사망.전조5년총생존솔위59.1%.단순방료、동기방화료、유도화료+동기방화료、동기방화료+보조화료적5년총생존솔분별위17%、51%、68%、71%(X2=15.44,P=0.001),무복발생존솔분별위83%、77%、88%、93%(X2=2.34,P:0.505),무전이생존솔분별위17%、54%、72%、80%(X2=19.28,P=0.000).결론 유도화료+동기방화료급동기방화료+보조화료방식대N3기비인암환자비단순동기방화료경구우세,최유효치료방식유대수궤연구증실.
Objective Nasopharyngeal carcinoma patients with stage N3 disease are prone to develop distant metastasis even treated with standard concurrent chemoradiotherapy(CRT).The aim of this study is to compare the ettlcacy of difierent chemotherapy sequences in these patients.Methotis All patients with histologically proven,carcinoma of the nasopharynx treated between July 1999 and November 2003 were restaged according to the AJCC 2002 stage classification system.A total of 114 patients had AJCC N3 diseases were analyzed retrospectively.Patients were treated by conventional RT technique using 6 MV photons or 60 Coγ-ray with 1.8-2.0 Gy per fraction,5 fractions a week,to a planned dose of 70 Gy.The prophylactic irradiation dose of the neck wss 54-60 Gy.Any positive lymph node was boosted to a total dose of 60-68 Gy.All patients received cisplatin-based chemotherapy of difierent sequences but 9 patients RT alone.CRT regimen was delivered in 37 patients,neoadjuvant chemotherapy(NACT)+CRT regimen in 53 patients and CRT+adjuvant chemotherapy(AC)regimen in 15 patients.Results The prophylactic irradiation dose of the neck wss 54-60 Gy.Any positive lymph node was boosted to a total dose of 60-68 Gy.All patients received cisplatin-based chemotherapy of difierent sequences but 9 patients received RT alone.CRT regimen was delivered in 37 patients,neoadjuvant chemotherapy(NACT)+CRT regimen in 53 patients and CRT+adjuvant chemotherapy(AC)regimen in 15 patients.Results The median follow up time was 54 months(3-117months).The 5-year overall survival rate was 59.1%in whole groups,and with 17%,51%,68%and 71%in RT,CRT,NACT+CRT and CRT+AC group,respectively(X2=15.44,P=0.001).The 5-year relapse-free survival rates were 83%,77%,88%and 93%in RT,CRT,NACT+CRT and CRT+AC group,respectively(X2=2.34,P=0.505).The 5-year metastasis-free survival rates were 17%,54%,72%and 80%in RT,CRT,NACT+CRT and CRT+AC group,respectively(X2=19.28,P=0.000).Conclusions The NACT+CRT and CRT+AC regimens were more effective than CRT alone for N3 disease in the current study.Large prospective,randomized clinieal studies are warranted.
