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Prognostic factors of locally persistent and recurrent nasopharyngeal carcinoma treated with stereotactic radiotherapy
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1004-4221.2007.06.001
- Key Word:
- 鼻咽肿瘤/分次立体定向放射疗法;局部残留或复发;预后因素
Abstract： 目的 分析局部残留和复发鼻咽癌分次立体定向放疗(FSRT)的预后因素.方法 采用FSRT治疗鼻咽癌常规放疗后局部残留和复发患者共90例,除3例治疗前已发生远处转移外,余87例(34例残留,53例复发)纳入分析.其中肿瘤位于鼻咽腔内、外者分别为44、43例;中位肿瘤体积为5.7 cm3(0.8～24.7 cm3);残留和复发病灶FSRT的中位处方剂量分别为18 Gy分3次和48 Gy分6次.用Kaplan-Meier法计算无局部失败生存率(LFFS)和疾病相关生存率(DSS),用Logrank法和Cox模型分别进行单因素和多因素的预后分析.结果 中位随访时间为24.9个月(3.3～86.3个月),1、2、3、4年LFFS和DSS分别为90%、83%、81%、75%和84%、77%、61%、56%.单因素分析显示肿瘤体积(≤或＞5 cn3)对患者DSS有影响(P=0.015).多因素分析显示肿瘤体积和病灶类型(残留或复发)是影响DSS的独立因素(P＜0.05).残留组和复发组晚期副反应发生率分别为9%和26%.结论 FSRT治疗残留和复发鼻咽癌可得到较好局部控制率和生存率,复发病灶和较大肿瘤体积是预后不良的独立影响因素.
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