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不同诱导化疗方案联合放疗治疗鼻咽癌疗效分析
引用本文:尹珍珍,王优优,张希梅,王凤明,赵路军,王平,王佩国,袁智勇. 不同诱导化疗方案联合放疗治疗鼻咽癌疗效分析[J]. 中国肿瘤临床, 2018, 45(4): 179-184. DOI: 10.3969/j.issn.1000-8179.2018.04.235
作者姓名:尹珍珍  王优优  张希梅  王凤明  赵路军  王平  王佩国  袁智勇
作者单位:天津医科大学肿瘤医院放射治疗科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中 心(天津市300060)
摘    要:  目的  分析诱导化疗后行调强放疗的鼻咽癌患者,对比不同诱导化疗方案的治疗疗效。  方法  回顾性分析2012年1月至2014年6月天津医科大学肿瘤医院初治170例Ⅱ~Ⅳb期鼻咽癌患者临床资料,其中男性126例,女性44例;Ⅱ期27例,Ⅲ期105例,Ⅳa~b期38例。  结果  全组中位随访时间34个月。3年总生存率、局部区域控制率、无病生存率和无远处转移生存率分别为82.8%、91.5%、76.7%和69.1%。多因素分析发现,含紫杉醇+顺铂的诱导化疗方案较顺铂+5-氟尿嘧啶疾病进展(HR:1.820,95%CI:1.013~3.271,P=0.045)及远处转移风险(HR:2.240,95%CI:1.017~4.090,P=0.045)显著降低。  结论  含紫杉醇+顺铂的诱导化疗方案较顺铂+5-氟尿嘧啶方案显著延长鼻咽癌患者无病生存率和无远处转移生存率。 

关 键 词:鼻咽癌   诱导化疗   调强放疗   疗效
收稿时间:2017-11-16

Treatment outcomes of different induction chemotherapy regimens combined with intensity-modulated radiotherapy in nasopharyngeal carcinoma
Affiliation:Departments of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin 300060, China
Abstract:  Objective  The role of induction chemotherapy (IC) and preferred regimens is not very clear in non-endemic nasopharyngeal carcinoma (NPC) in northern China.  Methods  A total of 170 pathologically proven locoregional advanced NPCs between January 2012 and December 2014 were included in this analysis. One hundred and twenty-six were men and 44 patients were women. According to the American Joint Committee on Cancer (AJCC) 7th stage system, 48 patients were T1-2 and 77 patients were T3-4; 48 patients were N0-1 and 122 patients were N2-3; 27 patients were stage Ⅱ, 105 patients were stage Ⅲ, and 38 patients were stage IVa-b.  Results  The median follow-up time was 34 months. The 3-year overall survival (OS), locoregional failure-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 82.8%, 91.5%, 76.7%, and 69.1%, respectively. Multivariate analyses showed that IC with TPF (docetaxel, carboplatin, and fluorouracil) or TP (docetaxel and cisplatin) presented superior DFS and DMFS compared with PF (cisplatin+5-FU) [DFS-hazard ratio (HR): 1.820, 95% confidence interval (CI): 1.013-3.271, P=0.045; DMFS-HR: 2.240, 95% CI: 1.017-4.090, P=0.045].  Conclusions  The IC regimens appeared to affect patients' outcomes, and TP-containing IC regimens conferred better DFS and DMFS than PF regimens. 
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