CAJ | 학술논문

目的：回顾性成组配对分析早期鼻咽癌单纯IMRT与IMRT同期化疗疗效及不良反应。方法2009—2010年共98例T1?2 N1 M0期鼻咽癌患者行单纯放疗或同期放化疗，筛选出39对患者进行疗效及不良反应对比分析。 Kaplan?Meier法计算生存率且Logrank法检验。结果3年随访率为95％。单纯IMRT组和同期放化疗组3年OS率分别为97％、95％（ P＝0?411），PFS率分别为97％、92％（ P＝0?301），LRFS率分别为97％、97％（ P＝0?606），DMFS率分别为100％、92％（ P＝0?082）。白细胞减少、贫血、血小板减少发生率同期放化疗组大于单纯IMRT组（P＝0?000、0?000、0?000），单纯IMRT组与同期放化疗组3级口腔口咽黏膜炎发生率分别为26％和36％（ P＝0?093），听力下降发生率分别为41％、62％（ P＝0?100）。结论同期化疗联合IMRT未能提高早期鼻咽癌T1?2 N1期患者OS、PFS、LRFS率，亦未能降低DMFS率；且血液毒性、3级黏膜炎、听力下降发生率较单纯IMRT组高。
목적：회고성성조배대분석조기비인암단순IMRT여IMRT동기화료료효급불량반응。방법2009—2010년공98례T1?2 N1 M0기비인암환자행단순방료혹동기방화료，사선출39대환자진행료효급불량반응대비분석。 Kaplan?Meier법계산생존솔차Logrank법검험。결과3년수방솔위95％。단순IMRT조화동기방화료조3년OS솔분별위97％、95％（ P＝0?411），PFS솔분별위97％、92％（ P＝0?301），LRFS솔분별위97％、97％（ P＝0?606），DMFS솔분별위100％、92％（ P＝0?082）。백세포감소、빈혈、혈소판감소발생솔동기방화료조대우단순IMRT조（P＝0?000、0?000、0?000），단순IMRT조여동기방화료조3급구강구인점막염발생솔분별위26％화36％（ P＝0?093），은력하강발생솔분별위41％、62％（ P＝0?100）。결론동기화료연합IMRT미능제고조기비인암T1?2 N1기환자OS、PFS、LRFS솔，역미능강저DMFS솔；차혈액독성、3급점막염、은력하강발생솔교단순IMRT조고。
Objective To retrospectively analyze the efficacy and toxicity of intensity?modulated radiotherapy ( IMRT) alone and IMRT with concurrent chemotherapy ( CRT) in the treatment of early?stage nasopharyngeal carcinoma ( NPC) using pairwise group comparison. Methods A total of 98 patients with stage T1?2N1M0 NPC were treated with IMRT alone or CRT from 2009 to 2010, and 39 pairs out of them were selected for comparison of efficacy and toxicity. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. Results The 3?year follow?up rate was 95%. There were no significant differences in the 3?year overall survival ( OS ) , progression?free survival ( PFS ) , local recurrence?free survival ( LRFS ) , and distant metastasis?free survival ( DMFS ) rates between the IMRT alone group and the CRT group ( 97% vs. 95%, P=0?411;97% vs. 92%, P=0?301;97% vs. 97%, P=0?606;100% vs. 92%, P=0?082) . The incidence rates of leucopenia, anemia, and thrombocytopenia were significantly higher in the CRT group than in the IMRT alone group ( P=0?000;P=0?000;P=0?000 ) . There were no significant differences in the incidence rates of grade 3 oral mucositis and hearing loss between the IMRT alone group and the CRT group ( 26% vs. 23%, P= 0?093;41% vs. 62%, P= 0?100 ) . Conclusions CRT fails to increase the OS, PFS, and LRFS rates and reduce the DMFS rate in patients with stage T1?2 N1 NPC. Moreover, CRT results in higher incidence rates of hematotoxicity, grade 3 mucositis, and hearing loss than IMRT alone.