Paper - WANFANG MED ONLINE

You Position: Home > Paper

Ten-year experience of radical radiotherapy for nasopharyngeal carcinoma: analysis of 905 patients

( views:120, downloads:874 )

Author:: No author available

Journal Title:: CHINESE JOURNAL OF RADIATION ONCOLOGY

Issue:: 4

DOI:: 10.3760/j.issn:1004-4221.2006.04.004

Key Word:: 鼻咽肿瘤/放射疗法;预后;因素分析,统计学

Abstract：目的分析20世纪最后10年内收治的鼻咽癌患者的根治性放疗结果,探求更好的治疗方案.方法10年内首程根治性放疗患者共905例.分析放疗患者的预后、失败模式及其影响因素等.生存率用Kaplan-Meier法计算,组间差别用Logrank检验,失败模式的影响因素组间差别用x2检验.结果全组5和10年总生存率、局部控制率、无瘤生存率分别为76.1%和66.5%、81.7%和76.7%、58.4%和52.1%.单因素分析显示年龄、卡氏评分、贫血、T和N分期及临床分期是影响总生存率和无瘤生存率的因素.多因素分析显示年龄、贫血是总生存率的独立预后因素,年龄、T和N分期及临床分期是无瘤生存率的独立预后因素.共有254例治疗后出现失败,失败率为28.0%.首次失败为局部未控104例(40.9%)、远处转移124例(49.0%).骨转移是最常见部位,其次是肝和肺.结论目前鼻咽癌根治性放疗已取得较好成绩.治疗前改善患者一般状况、纠正贫血、早期发现患者、降低T4和(或)N3期患者的远处转移是进一步提高疗效的研究方向.

Reference

[1]肖建平,徐国镇,高黎,等.鼻咽癌初程放疗后残存的分次X刀治疗初探[J].2005,(2).
[2]贺蓓娃,邹勤舟,张福正,等.鼻咽癌放射治疗后肿瘤残留与疗效的临床分析[J].2004,(3).
[3]Calais G.Final Results of the 94-01 French Head and Neck Oncology and Radiotherapy Group Randomized Trial Comparing Radiotherapy Alone With Concomitant Radiochemotherapy in Advanced-Stage Oropharynx Carcinoma.[J].2004,22(1).
[4]Leemans ChR,Slotman BJ,Berkhof J,etc.The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature.[J].2004,22(22).
[5]Lee N,Poon I,Akazawa P,etc.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience.[J].2002,53(1).
[6]D X, Qin,Y H, Hu,J H, Yan,etc.Analysis of 1379 patients with nasopharyngeal carcinoma treated by radiation.[J].1988,61(6).
[7]Pignon JP,Bourhis J,Domenge C,etc.Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer.[J].2000,355(9208).
[8]Ensley JF,Schuller DE,Giri PG,etc.Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099.[J].1998,16(4).
[9]Glaser CM,Millesi W,Kornek GV,etc.Impact of hemoglobin level and use of recombinant erythropoietin on efficacy of preoperative chemoradiation therapy for squamous cell carcinoma of the oral cavity and oropharynx.[J].2001,50(3).
[10]Michael I. Koukourakis,Routh M. Whitehouse,Alexandra Giatromanolaki,etc.Predicting Distant Failure in Nasopharyngeal Cancer[J].1996,106(6).
[11]Dodge RK,Clough RW,Brizel DM,etc.Oxygenation of head and neck cancer: changes during radiotherapy and impact on treatment outcome.[J].1999,53(2).
[12]Forastiere AA,Weber R,Chao C,etc.Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer.[J].2003,349(22).
[13]D T, Chua,J S, Sham,W I, Wei,etc.The predictive value of the 1997 American Joint Committee on Cancer stage classification in determining failure patterns in nasopharyngeal carcinoma.[J].2001,92(11).
[14]J S, Sham,D, Choy,P H, Choi.Nasopharyngeal carcinoma: the significance of neck node involvement in relation to the pattern of distant failure.[J].1990,63.
[15]Chow E,Waldron J,Liu FF,etc.Radiotherapy alone in patients with advanced nasopharyngeal cancer: comparison with an intergroup study. Is combined modality treatment really necessary?[J].2002,63(3).
[16]Hochster H,Cooper JS,Lee H,etc.Improved outcome secondary to concurrent chemoradiotherapy for advanced carcinoma of the nasopharynx: preliminary corroboration of the intergroup experience.[J].2000,47(4).
[17]Pou A,Sanguineti G,Licitra L,etc.Timing of chemoradiotherapy and patient selection for locally advanced nasopharyngeal carcinoma.[J].2003,15(8).
[18]Rube C,Schafer U,Frommhold H,etc.Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial.[J].2003,362(9392).
[19]Grant WH,Chiu JK,Mai WY,etc.Dosimetric predictors of xerostomia for head-and-neck cancer patients treated with the smart (simultaneous modulated accelerated radiation therapy) boost technique.[J].2003,56(1).