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The outcome of stage Ⅱ nasopharyngeal carcinoma treated by definitive conventional fractionation radiotherapy

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF RADIATION ONCOLOGY
Issue:
2
DOI:
10.3760/cma.j.issn.1004-4221.2009.02.083
Key Word:
鼻咽肿瘤,临床Ⅱ期/放射疗法;常规分割;预后;Nasopharyngeal neoplasms,clinical Stage Ⅱ/radiotherapy;Conventional fractiona-tion;Prognosis

Abstract: Objective To evaluate the outcome of Stage Ⅱ nasopharyngeal carcinoma(NPC) trea-ted by conventional fractionation radiotherapy. Methods From January 1990 to May 1999,216 patients with untreated stage Ⅱ NPC were irradiated by 6 MV photons and 9-12 MeV electrons with linear accelera-tor. Of 26 patients with residual lesions after 70 Gy irradiation, 18 received intracavitary brachytherapy and 8 received stereotactic irradiation boost. Results The 10-year overall survival (OS) of patients with T2 N0 M0, T1N1M0 and T2N1M0 disease were 90%, 80% and 75.2% (χ2 = 3.26, P =0. 200), respectively. The corresponding disease-free survival(DFS) and distant metastasis-free survival(DMFS) were 79% ,60% and 62.6% (χ2 = 5.87, P = 0.053) ;90% ,74% and 68.0% (χ2 = 7.09, P = 0. 030), respectively. In uni-variate analysis, T stage had no impact on OS, DFS or DMFS (χ2 = 0.44, P = 0. 500 ; χ2 = 0.44, P = 0.500 ; χ2 = 0.25, P = 0. 610), while N stage significantly influenced DFS and DM FS (χ2 = 5.86, P = 0. 015 ; χ2 = 5.31 ,P = 0. 021). Multivariate analysis showed that N stage was an independent prognostic factor for DFS and DMFS(χ2=5.03,P=0.025;χ2=6.47,P=0.01). Conclusions Stage Ⅱ NPCwithposifivelymph node treated by radiotherapy alone is inadequate. In order to improve DFS and DMS, combined chemo-radio-therapy should be considered.

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