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
5期
369-373
,共5页
冯梅%范子煊%黎杰%张鹏%李涛%文浩%王捷%王建%王冀川%王卫东%郎锦义
馮梅%範子煊%黎傑%張鵬%李濤%文浩%王捷%王建%王冀川%王衛東%郎錦義
풍매%범자훤%려걸%장붕%리도%문호%왕첩%왕건%왕기천%왕위동%랑금의
鼻咽肿瘤/放射疗法%放射疗法,调强%预后
鼻嚥腫瘤/放射療法%放射療法,調彊%預後
비인종류/방사요법%방사요법,조강%예후
Nasopharyngeal neoplasms/radiotherapy%Radiotherapy,intensity-modulated%Prognosis
目的 评价本院鼻咽癌调强放疗(IMRT)的远期疗效和预后因素。方法 回顾分析2001 -2004年进行IMRT的582例初治鼻咽癌患者的临床结果,其中Ⅰ、Ⅱ、Ⅲ、Ⅳa期分别为36、144、224、178例。所有患者鼻咽和上颈部靶区均采用NOMOS的IMRT技术。运用美国放疗肿瘤组织标准评价急慢性不良反应,Kaplan-Meier法进行生存率分析,多因素预后分析采用Cox回归模型。结果 随访率为93.5％。5年局部控制率、区域控制率、无远处转移生存率、无瘤生存率、疾病特异生存率和总生存率分别为89.8％、95.2％、74.1％、69.6％、83.2％和77.1％。局部复发29例,区域复发13例,远处转移117例。3级急性和慢性不良反应分别为44.5％(唾液腺、口腔黏膜和皮肤)和4.2％。多因素分析表明影响总生存率的独立预后因素为临床分期、N分期、放疗中断时间、治疗前血红蛋白含量、体重降低幅度和化疗。结论 IMRT鼻咽癌获得了较好的远期疗效和生存质量;临床分期和N分期是影响总生存率的预后因素;远处转移是治疗失败的主要因素;急慢性不良反应主要为1～2级。
目的 評價本院鼻嚥癌調彊放療(IMRT)的遠期療效和預後因素。方法 迴顧分析2001 -2004年進行IMRT的582例初治鼻嚥癌患者的臨床結果,其中Ⅰ、Ⅱ、Ⅲ、Ⅳa期分彆為36、144、224、178例。所有患者鼻嚥和上頸部靶區均採用NOMOS的IMRT技術。運用美國放療腫瘤組織標準評價急慢性不良反應,Kaplan-Meier法進行生存率分析,多因素預後分析採用Cox迴歸模型。結果 隨訪率為93.5％。5年跼部控製率、區域控製率、無遠處轉移生存率、無瘤生存率、疾病特異生存率和總生存率分彆為89.8％、95.2％、74.1％、69.6％、83.2％和77.1％。跼部複髮29例,區域複髮13例,遠處轉移117例。3級急性和慢性不良反應分彆為44.5％(唾液腺、口腔黏膜和皮膚)和4.2％。多因素分析錶明影響總生存率的獨立預後因素為臨床分期、N分期、放療中斷時間、治療前血紅蛋白含量、體重降低幅度和化療。結論 IMRT鼻嚥癌穫得瞭較好的遠期療效和生存質量;臨床分期和N分期是影響總生存率的預後因素;遠處轉移是治療失敗的主要因素;急慢性不良反應主要為1～2級。
목적 평개본원비인암조강방료(IMRT)적원기료효화예후인소。방법 회고분석2001 -2004년진행IMRT적582례초치비인암환자적림상결과,기중Ⅰ、Ⅱ、Ⅲ、Ⅳa기분별위36、144、224、178례。소유환자비인화상경부파구균채용NOMOS적IMRT기술。운용미국방료종류조직표준평개급만성불량반응,Kaplan-Meier법진행생존솔분석,다인소예후분석채용Cox회귀모형。결과 수방솔위93.5％。5년국부공제솔、구역공제솔、무원처전이생존솔、무류생존솔、질병특이생존솔화총생존솔분별위89.8％、95.2％、74.1％、69.6％、83.2％화77.1％。국부복발29례,구역복발13례,원처전이117례。3급급성화만성불량반응분별위44.5％(타액선、구강점막화피부)화4.2％。다인소분석표명영향총생존솔적독립예후인소위림상분기、N분기、방료중단시간、치료전혈홍단백함량、체중강저폭도화화료。결론 IMRT비인암획득료교호적원기료효화생존질량;림상분기화N분기시영향총생존솔적예후인소;원처전이시치료실패적주요인소;급만성불량반응주요위1～2급。
Objective To evaluate the long-term results and prognostic factors in 582 nasopharyngeal carcinoma ( NPC ) patients treated by intensity modulated radiotherapy ( IMRT ) . Methods 582 newly diagnosed NPC patients treated by IMRT in Sichuan cancer hospital from Jan. 2001 to Dec. 2004were reviewed. According to 2002UICC staging system, there were 36 stage Ⅰ , 144 stage Ⅱ , 224 stage Ⅲ, 178 stage Ⅳa. The Kaplan-Meier method was used to calculate the survival rate. Acute and late toxicities were graded according to the radiation therapy oncology group (RTOG) radiation morbidity scoring criteria. Results The follow up rate was 93.5％. The 5-year local control, regional control, distant metastasis-free survival, disease free survival, disease specific survival and overall survival rate was 89. 8％,95. 2％, 74. 1％, 69.6％, 83.2％ and 77. 1％. There were 29, 13 and 117 patients who had developed local, regional and distant recurrence respectively. The incidence of grade 3 acute ( salivary gland、 oral mucosa and skin) and late toxicity was 44. 5％ and 4. 2％. No grade 4 acute and late toxicity reaction was found. Multivariate analysis showed that clinical stage, N stage, radiotherapy interruption, age, HGB and weight loss were the independent prognostic factors for the overall survival. Conclusions NPC treated with IMRT could get good long-term survival with high quality of life. The clinical stage and N stage were the main prognostic factors for the overall survival. The acute and late toxicities were mainly grade 1 and 2.Distant metastasis is the main cause of treatment failure.
