实用癌症杂志
實用癌癥雜誌
실용암증잡지
THE PRACTICAL JOURNAL OF CANCER
2014年
8期
946-950
,共5页
舒禹先%敖帆%吴志瑛%汤轶强
舒禹先%敖帆%吳誌瑛%湯軼彊
서우선%오범%오지영%탕질강
鼻咽肿瘤/放射治疗%调强放疗%同期化疗%预后
鼻嚥腫瘤/放射治療%調彊放療%同期化療%預後
비인종류/방사치료%조강방료%동기화료%예후
Nasopharyngeal neoplasm%Intensity modulated Radiotherapy%Concurrent chemotherapy%Prognosis
目的:探讨鼻咽癌调强放射治疗( IMRT)联合化疗的初步疗效及预后因素。方法初诊鼻咽癌患者99例,处方剂量为PGTVnx(鼻咽部))68~76 Gy/30-33 F,PGTVnd(颈部转移淋巴结肿瘤靶区)66~70 Gy/30-33 F,PCTV1(临床靶区)60 Gy/30-33 F,下颈部及锁骨上采用下颈前切线野常规放疗50~54 Gy/25-27 F。58例Ⅲ~Ⅳa 期患者采用以铂类为基础的同期化疗。结果中位随访时间36个月(8~77个月),随访率97.9%。3年无进展生存率(PF-SR)、总生存率(OSR)、无复发生存率(RFSR)、无转移生存率(DMSFR)及局部控制率(LCR)分别为83.5%、89.0%、86.8%、90.6%及92.8%。单因素分析显示N或T分期、临床分期、放疗剂量及化疗并不影响PFSR,RFSR,RFSR 和DMSFR(P>0.05)。多因素分析显示仅患者年龄是总生存率的独立影响因素(P=0.042),说明同期化疗未能获益。结论单纯IMRT与IMRT联合化疗一样可取得良好的疗效,但仍存在复发、转移问题。
目的:探討鼻嚥癌調彊放射治療( IMRT)聯閤化療的初步療效及預後因素。方法初診鼻嚥癌患者99例,處方劑量為PGTVnx(鼻嚥部))68~76 Gy/30-33 F,PGTVnd(頸部轉移淋巴結腫瘤靶區)66~70 Gy/30-33 F,PCTV1(臨床靶區)60 Gy/30-33 F,下頸部及鎖骨上採用下頸前切線野常規放療50~54 Gy/25-27 F。58例Ⅲ~Ⅳa 期患者採用以鉑類為基礎的同期化療。結果中位隨訪時間36箇月(8~77箇月),隨訪率97.9%。3年無進展生存率(PF-SR)、總生存率(OSR)、無複髮生存率(RFSR)、無轉移生存率(DMSFR)及跼部控製率(LCR)分彆為83.5%、89.0%、86.8%、90.6%及92.8%。單因素分析顯示N或T分期、臨床分期、放療劑量及化療併不影響PFSR,RFSR,RFSR 和DMSFR(P>0.05)。多因素分析顯示僅患者年齡是總生存率的獨立影響因素(P=0.042),說明同期化療未能穫益。結論單純IMRT與IMRT聯閤化療一樣可取得良好的療效,但仍存在複髮、轉移問題。
목적:탐토비인암조강방사치료( IMRT)연합화료적초보료효급예후인소。방법초진비인암환자99례,처방제량위PGTVnx(비인부))68~76 Gy/30-33 F,PGTVnd(경부전이림파결종류파구)66~70 Gy/30-33 F,PCTV1(림상파구)60 Gy/30-33 F,하경부급쇄골상채용하경전절선야상규방료50~54 Gy/25-27 F。58례Ⅲ~Ⅳa 기환자채용이박류위기출적동기화료。결과중위수방시간36개월(8~77개월),수방솔97.9%。3년무진전생존솔(PF-SR)、총생존솔(OSR)、무복발생존솔(RFSR)、무전이생존솔(DMSFR)급국부공제솔(LCR)분별위83.5%、89.0%、86.8%、90.6%급92.8%。단인소분석현시N혹T분기、림상분기、방료제량급화료병불영향PFSR,RFSR,RFSR 화DMSFR(P>0.05)。다인소분석현시부환자년령시총생존솔적독립영향인소(P=0.042),설명동기화료미능획익。결론단순IMRT여IMRT연합화료일양가취득량호적료효,단잉존재복발、전이문제。
Objective Objective To evaluate the preliminary efficacy and prognostic factors of nasopharyngeal carcinoma ( NPC treated by intensity modulated radiotherapy ( IMRT ) and concurrent platin-based chemotherapy .Methods 99 patients were retrospectively analyzed .The prescription doses of nasopharynx ( PGTVnx) was 68~76 Gy/30-33 F,the neck lymph node metastasis tumor target area ( PGTVnd) was 66~70 Gy/30-33 F,high-risk clinical target volume ( PCTV1 ) was 60 Gy/30 F,and low-risk clinical target volume (PCTV2)was 50~54 Gy/25-27 F.58 stagesⅢ-Ⅳpatients received platin-based chemoradiothera-py.Results The median follow up time was 36(8~77) months.The follow up rate was 97.9%.The 3-year progression-free sur-vival rate ( PFSR) ,overall survival rate ( OSR) ,recurrence free survival rate ( RFSR) ,distant metastasis-free survival rate ( DMS-FR) and local control rate (LCR)were 83.5%、89.0%、86.8%、90.6%and 92.8%.Univariate analysis showed that stage N or T,TNM stage,the prescribed dose and chemotherapy were not associated with PFSR ,RFSR and DMSFR.Multivariate analysis showed that age was independent factor affecting OS (P<0.05).CCRT did not significantly improve the overall and disease-free survival rates of advanced NPC patients .Conclusion IMRT with or without chemotherapy can improve the survival of NPC pa-tients.Distant metastasis and recurrence are major causes of failure .