中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
3期
196-200
,共5页
易俊林%高黎%黄晓东%罗京伟%肖建平%李素艳%王凯%张世平%曲媛%徐国镇
易俊林%高黎%黃曉東%囉京偉%肖建平%李素豔%王凱%張世平%麯媛%徐國鎮
역준림%고려%황효동%라경위%초건평%리소염%왕개%장세평%곡원%서국진
鼻咽肿瘤/调强放射疗法%鼻咽肿瘤/同期放化疗法%预后
鼻嚥腫瘤/調彊放射療法%鼻嚥腫瘤/同期放化療法%預後
비인종류/조강방사요법%비인종류/동기방화요법%예후
Nasopharyngeal neoiplasms/intensity-modulated radiotherapy%Nasopharyngeal neoiplasms/concurrent chemoradiotherapy%Prognosis
目的 总结鼻咽癌调强放疗(IMRT)的远期生存与影响因素.方法 本院2001-2009年采用IMRT技术治疗初程鼻咽癌患者416例,鼻咽原发灶、阳性淋巴结的大体肿瘤体积处方剂量为70～78 Gy,临床靶体积处方剂量为60 Gy,淋巴结阴性引流区处方剂量为50～56 Gy.Ⅲ+Ⅳ期333例中187例接受以顺铂30 mg/m2每周1次为主的同期化疗.Kaplan-Meier法计算生存率并Logrank法检验和单因素预后分析,Cox法多因素预后分析.结果 随访率98.0％,随访超过5年的158例.影响总生存的因素有性别(x2=4.59,P=0.03)、年龄(x2=11.20,P=0.00)、T分期(x2=19.40,P=0.00),N分期(x2=18.00,P=0.00),T分期影响局部控制(x2=34.80,P=0.00),T分期、N分期均影响无瘤生存率和无远处转移生存(x2=33.50、21.20,P=0.00、0.00和x2=11.90、14.60,P=0.01、0.01).Ⅲ+Ⅳ期333例中同期放化疗(187例)和单纯放疗(146例)的5年局部控制率为82.2％和90.7％(x2=1.72,P=0.19)、总生存率为70.2％和83.4％(x2=1.42,P=0.23)、无瘤生存率为62.8％和73.2％(x2=2.83,P=0.09)、无远处转移生存率为78.0％和83.2％(x2=0.37,P=0.55).结论 鼻咽癌IMRT取得较好疗效,但同期化疗的作用仍有待进一步证实.
目的 總結鼻嚥癌調彊放療(IMRT)的遠期生存與影響因素.方法 本院2001-2009年採用IMRT技術治療初程鼻嚥癌患者416例,鼻嚥原髮竈、暘性淋巴結的大體腫瘤體積處方劑量為70～78 Gy,臨床靶體積處方劑量為60 Gy,淋巴結陰性引流區處方劑量為50～56 Gy.Ⅲ+Ⅳ期333例中187例接受以順鉑30 mg/m2每週1次為主的同期化療.Kaplan-Meier法計算生存率併Logrank法檢驗和單因素預後分析,Cox法多因素預後分析.結果 隨訪率98.0％,隨訪超過5年的158例.影響總生存的因素有性彆(x2=4.59,P=0.03)、年齡(x2=11.20,P=0.00)、T分期(x2=19.40,P=0.00),N分期(x2=18.00,P=0.00),T分期影響跼部控製(x2=34.80,P=0.00),T分期、N分期均影響無瘤生存率和無遠處轉移生存(x2=33.50、21.20,P=0.00、0.00和x2=11.90、14.60,P=0.01、0.01).Ⅲ+Ⅳ期333例中同期放化療(187例)和單純放療(146例)的5年跼部控製率為82.2％和90.7％(x2=1.72,P=0.19)、總生存率為70.2％和83.4％(x2=1.42,P=0.23)、無瘤生存率為62.8％和73.2％(x2=2.83,P=0.09)、無遠處轉移生存率為78.0％和83.2％(x2=0.37,P=0.55).結論 鼻嚥癌IMRT取得較好療效,但同期化療的作用仍有待進一步證實.
목적 총결비인암조강방료(IMRT)적원기생존여영향인소.방법 본원2001-2009년채용IMRT기술치료초정비인암환자416례,비인원발조、양성림파결적대체종류체적처방제량위70～78 Gy,림상파체적처방제량위60 Gy,림파결음성인류구처방제량위50～56 Gy.Ⅲ+Ⅳ기333례중187례접수이순박30 mg/m2매주1차위주적동기화료.Kaplan-Meier법계산생존솔병Logrank법검험화단인소예후분석,Cox법다인소예후분석.결과 수방솔98.0％,수방초과5년적158례.영향총생존적인소유성별(x2=4.59,P=0.03)、년령(x2=11.20,P=0.00)、T분기(x2=19.40,P=0.00),N분기(x2=18.00,P=0.00),T분기영향국부공제(x2=34.80,P=0.00),T분기、N분기균영향무류생존솔화무원처전이생존(x2=33.50、21.20,P=0.00、0.00화x2=11.90、14.60,P=0.01、0.01).Ⅲ+Ⅳ기333례중동기방화료(187례)화단순방료(146례)적5년국부공제솔위82.2％화90.7％(x2=1.72,P=0.19)、총생존솔위70.2％화83.4％(x2=1.42,P=0.23)、무류생존솔위62.8％화73.2％(x2=2.83,P=0.09)、무원처전이생존솔위78.0％화83.2％(x2=0.37,P=0.55).결론 비인암IMRT취득교호료효,단동기화료적작용잉유대진일보증실.
Objective To summarize the long term outcomes and prognostic factors of nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy.Methods From Nov 2001to Dec 2009,totally 416 newly diagnosed NPC patients was treated in our hospital.The prescribed dose was 70-78 Gy to the gross tumor volume and 70 Gy to the positive neck nodes,60 Gy to the clinical target volume,and 50-56 Gy to the clinically negative neck.Among 333 stage Ⅲ/Ⅳ patients according to the 2010 UICC staging system,187 received concurrent chemoradiotherapy with a regimen of weekly cisplatin 30mg/m2.Local control rate (LC),overall survival (OS),disease-hree survival (DFS) and distant metastasis-free survival (DMFS) were estimated using the Kaplan-Meier method.Results The follow up rate is 98.0％.158 patients was followed up more than 5 years.The 5 years LC,OS,DFS and DMFS of whole group were 87.7％,82.1％,71.8％ and 84.5％.Sex,Age,T stage and N stage were independent prognostic factors for OS (x2=4.59,11.20,19.40,18.00,P=0.03,0.00,0.00,0.00),T and N stage were independent prognostic factors for DFS (x2=33.50,21.20,P=0.00,0.00) and DMFS (x2=11.90,14.60,P=0.01,0.01).The 5 years LC,OS,DFS and DMFS for local-regional advanced disease with or without concurrent chemotherapy was 82.2％ and 90.7％ (x2=1.72,P=0.19),70.2％ and 83.4％ (x2=1.42,P=0.23),62.8％ and 73.2％ (x2=2.83,P=0.09),78.0％ and 83.2％ (x2=0.37,P=0.55)respectively.Conclusions The long term outcomes of nasopharyngeal carcinoma treated by intensitymodulated radiotherapy was encouraged.The role of concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy needs further investigated.
