摘要
目的 分析生长在西北地区的早期鼻咽癌(T1～2N0～1期)患者调强放疗联合化疗的疗效及预后因素.方法 回顾分析2006-2009年本院收治的58例早期鼻咽癌患者临床资料.KaplanMeier法计算生存率,并Logrank法检验和单因素分析.结果 随访率100％,随访满2、3年者分别为50、46例.全组1、2、3年生存率分别为98％、94％、91％.分层分析显示T1N0 ～1、T2N0期与T2N1期3年总生存率、局部无复发生存率、无远处转移生存率不同,分别为100％和74％、100％和81％、100％和87％(x2=5.74、4.95、4.24,P=0.01、0.03、0.04);全组放化疗与单纯放疗的不同,分别为100％与85％、100％与85％、100％与88％( x2 =4.02、4.12、4.84,P=0.04、0.03、0.02);T2N1期中放化疗与单纯放疗的也不同,分别为100％与79％、100％与79％、100％与80％( x2=5.28、4.84、4.72,P =0.03、0.04、0.04).单因素分析显示N分期、临床分期、放化疗与生存相关(x2=5.39、5.74、4.02,P =0.02、0.01、0.04).结论 早期鼻咽癌各亚组中T2N1期是远处转移的高危亚组,调强放疗联合化疗可能提高该组病例的无复发生存率、无远处转移生存率及总生存率.
Abstract
Objective To evaluate the therapeutic efficacy and prognostic factors of intensity-modulated radiotherapy combined with chemotherapy for early-stage nasopharyngeal carcinoma patients in northwest China. Methods From January 2006 to December 2009,58 patients with early-stage nasopharyngeal carcinoma were treated with IMRT in Xijing hospital,the clinical data were analyzed retrospectively.Survival rates was calculated by the Kaplan-Meier method and the differences was compared by the Logrank test.Univariate analysis method was use to identify all significant factors.Results The follow-up rate was 100％.The follow-up time of 46 patients was more than 3 years.The 1-,2 and 3-year survival were 98％,94％ and 91％,respectively.The 3-year overall survival (OS),local recurrence-free survival (LRFS),distant metastasis-free surv ival (DMFS) for T1N0-1,T2N0 and T2N1 stage were 100％,100％,100％ and 74 ％,81％,87 ％,respectively ( x2 =5.74,P =0.01 ; x2 =4.95,P =0.03 ; x2 =4.24,P=0.04).The 3-year OS,LRFS,DMFS for IMRT combined with chemotherapy and IMRT alone were 100％,100％,100％ and 85％,85％,88％ respectively ( x2 =4.02,P =0.04; x2 =4.12,P =0.03 ; x2 =4.84,P =0.02).In T2N1 stage,IMRT combined with chemotherapy and IMRT alone were 100％,100％,100％ and 79％,79％,80％ respectively (x2 =5.28,P =0.03 ;x2 =4.84,P =0.04;x2 =4.72,P =0.04).In univariate analysis,N stage,clinical stage,IMRT combined with chemotherapy were significantly associated with the survival ( x2 =5.39,P =0.02 ; x2 =5.74,P =0.01 ; x2 =4.02,P =0.04).Conclusions In all early-stage nasopharyngeal carcinoma,T2N1 stage is a sub-group of high risk of distant metastasis.Combination of IMRT and chemotherapy may improve the LRFS,DMFS and OS in those patients.
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维普
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