CAJ | 학술논문

目的评价N晚期鼻咽癌根治性调强放疗(IMRT)的远期疗效及IMRT联合不同化疗模式对N晚期鼻咽癌患者预后影响.方法回顾分析2001-2008年间收治的179例N晚期鼻咽癌患者临床资料,其中单纯IMRT 33例,放化疗146例(同期放化疗71例、诱导化疗加同期放化疗66例,同期放化疗加辅助化疗9例).结果随访率96.5％,随访时间满5年者133例.全组5年总生存率为69.0％.单纯IMRT和放化疗的5年总生存率、无远处转移生存率、无复发生存率、无进展生存率分别为47.7％和73.7％ (x2=13.91,P=0.000)、49.2％和68.3％(x2=4.97,P=0.026)、74.5％和92.4％(x2=9.87,P=0.002)、37.5％和65.1％(x2=11.65,P =0.001),放化疗中同期放化疗、诱导化疗加同期放化疗、同期放化疗加辅助化疗的生存率相似,但诱导化疗加同期放化疗的无远处转移生存率比单纯IMRT的高(x2=4.65,P=0.031).结论 N晚期鼻咽癌患者单纯IMRT后远处转移率仍较高,诱导化疗加IMRT联合同期化疗也许是较为合理的治疗手段.
목적 평개N만기비인암근치성조강방료(IMRT)적원기료효급IMRT연합불동화료모식대N만기비인암환자예후영향.방법 회고분석2001-2008년간수치적179례N만기비인암환자림상자료,기중단순IMRT 33례,방화료146례(동기방화료71례、유도화료가동기방화료66례,동기방화료가보조화료9례).결과 수방솔96.5％,수방시간만5년자133례.전조5년총생존솔위69.0％.단순IMRT화방화료적5년총생존솔、무원처전이생존솔、무복발생존솔、무진전생존솔분별위47.7％화73.7％ (x2=13.91,P=0.000)、49.2％화68.3％(x2=4.97,P=0.026)、74.5％화92.4％(x2=9.87,P=0.002)、37.5％화65.1％(x2=11.65,P =0.001),방화료중동기방화료、유도화료가동기방화료、동기방화료가보조화료적생존솔상사,단유도화료가동기방화료적무원처전이생존솔비단순IMRT적고(x2=4.65,P=0.031).결론 N만기비인암환자단순IMRT후원처전이솔잉교고,유도화료가IMRT연합동기화료야허시교위합리적치료수단.
Objective To evaluate the long-term outcomes of patients with advanced N-stage nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) and the effects of IMRT combined with different chemotherapies on the patients' prognosis.Methods A retrospective analysis was performed on the clinical data of 179 patients with advanced N-stage NPC who were admitted to our hospital from January 2001 to January 2008.Of the 179 patients,33 received IMRT alone,and 146 received chemoradiotherapy (CRT).Among the 146 patients,71 received concurrent chemoradiotherapy (CCRT),66 received induction chemotherapy (IC) plus CCRT,and 9 received CCRT plus adjuvant chemotherapy (AC).Results The follow-up rate was 96.5％,and 133 patients were followed up for at least 5 years.The 5-year overall survival rate was 69.0％.The patients receiving IMRT alone and patients receiving CRT had 5-year overall survival rates of 47.7％ and 73.7％ (x2 =13.91,P =0.000),5-year distant metastasisfree survival (DMFS) rates of 49.2％ and 68.3％ (x2 =4.97,P =0.026),relapse-free survival rates of 74.5％ and 92.4％ (x2 =9.87,P =0.002),and progression-free survival rates of 37.5％ and 65.1％ (x2 =11.65,P =0.001).Among the patients receiving CRT,those receiving CCRT,IC plus CCRT,and CCRT plus AC had similar survival rates.IC plus CCRT resulted in a significantly higher DMFS than IMRT alone (x2 =4.65,P =0.031).Conclusions The distant metastasis rate is still high in patients with advanced N-stage NPC after IMRT,for whom IC plus concurrent chemotherapy and IMRT may be a better treatment regimen.