鼻咽癌调强放疗疗效及预后影响因素分析(附691例)

目的:回顾性分析我院采用调强放疗(intensity-modulated radiotherapy,IMRT)治疗鼻咽癌的疗效及预后影响因素.方法:收集2009年01月至2015年08月691例鼻咽癌患者的临床资料进行生存分析.结果:中位随访时间为62.8个月,全组患者5年总生存(overall survival,OS...

Analysis of the efficacy and prognostic factor of intensity-modulated radiotherapy for nasopharyngeal carcinoma(691 cases)

Objective:To retrospectively analyze the survival outcome and prognostic factors for patients with nasopharyngeal carcinoma(NPC) receiving intensity-modulated radiotherapy(IMRT).Methods:Clinical data of 691 patients with NPC receiving IMRT from January 2009 to August 2015 were collected.Survival analysis and prognostic factors were performed and analyzed.Results:The median follow-up time was 62.8 months.The 5-year overall survival rate(OS),disease-special survival rate(DSS),progression-free survival rate(PFS),locoregional recurrence free survival rate(LRFS) and distant metastasis free survival rate(DMFS) were 85.8%,86.5%,82.5%,90.7% and 89.4%,respectively.The 5-year LRFS and DMFS of phase Ⅰ,Ⅱ,Ⅲ and Ⅳ;were 100.0% and 100.0%,99.2% and 96.0%,93.5% and 92.7%,83.4% and 76.1%,respectively.A total of 109 patients died(102 died of tumor and 7 died of non-tumor).63 patients experienced relapse, 44 cases(70.0%) occurred within 3 years, and only 6 cases(9.5%) occurred over 5 years.72 cases metastasized, 63 cases(87.5%) occurred within 3 years, and only 1 case(1.4%) occurred over 5 years.Gender, T stage and N stage were the prognostic factors of OS,DSS,PFS,LRFS and DMFS.Patients with or without induction chemotherapy had 5-year DSS of 95.8% vs 89.3%(P<0.05) and 92.8% vs 85.5%(P<0.05) in stage Ⅲ and Ⅳ;NPC.While the 5-year DSS of patients with or without concurrent chemotherapy in stage Ⅲ and Ⅳ;NPC were 73.1% vs 68.9%(P<0.05) and 72.7% vs 53.0%(P<0.05).Conclusion:IMRT improves the survival rate of NPC patients.Recurrence or metastasis mainly occurs within 2 to 3 years after radiotherapy.Induction and concurrent chemotherapy improve the 5-year DSS of patients with locally advanced NPC.