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调强放疗条件下鼻咽癌原发肿瘤体积对预后的影响
引用本文:陈传本,潘建基,陈荔莎,柏朋刚,林少俊,张瑜,张秀春,费召东. 调强放疗条件下鼻咽癌原发肿瘤体积对预后的影响[J]. 中华放射肿瘤学杂志, 2012, 21(3): 205-208. DOI: 10.3760/cma.j.issn.1004-4221.2012.03.004
作者姓名:陈传本  潘建基  陈荔莎  柏朋刚  林少俊  张瑜  张秀春  费召东
作者单位:350014 福州,福建医科大学教学医院福建省肿瘤医院放疗科
摘    要:目的 探讨调强放疗条件下鼻咽癌原发肿瘤体积(PTV)对患者预后的影响。方法 330例接受调强放疗的鼻咽癌初治患者入组本研究。所有患者治疗前均行CT增强扫描,扫描图像资料输人三维治疗计划系统进行肿瘤轮廓勾画和PTV计算。在国际抗癌联盟2002年T分期框架内借助受试者工作特征曲线,将所有患者按PTV大小分为V1(<10 cm3)、V2(10~ 25 cm3)、V3(>25~50 cm3)、V4(>50 cm3)组。用 Kaplan Meier 法计算生存率并 Logrank 检验, Cox 回归模型分析原发肿瘤体积与患者预后的关系。结果 随访率100%。330例 鼻咽癌患者所测平均PTV为(34.2±27.1) cm3(0.4~153.7 cm3)。V1、V2、V3、V4组 3年总生存率分别为88.6%、90.0%、91.2%、74.2%(χ2=12.83, P=0.005)。PTV>50 cm3 (V4组)和≤50 cm3(V1+V2+V3) 者 3年无远处转移生存率和无瘤生存率及总生存率均明显下降 [77.4%∶89.9%(χ2=7.24, P=0.007)和64.5%∶85.1%(χ2=13.95, P=0.000) 及74.2%∶90.3% (χ2=11.76, P=0.001)]。多因素分析证实PTV同N分期一样,是影响患者生存的预后因素(χ2=0.00, P=2.580)。结论 鼻咽癌PTV可能是影响患者生存的一个重要的预后因素。

关 键 词:鼻咽肿瘤/调强放射疗法  计划靶体积  预后  
收稿时间:2011-09-02

Significance of primary tumor volume on prognosis in nasopharyngeal carcinoma treated by Intensity-modulated radiotherapy
CHEN Chuan-ben , PAN Jian-ji , CHEN Li-sha , BAI Peng-gang , LIN Shao-jun , ZHANG Yu , ZHANG Xiu-chun , FEI Zhao-dong. Significance of primary tumor volume on prognosis in nasopharyngeal carcinoma treated by Intensity-modulated radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 205-208. DOI: 10.3760/cma.j.issn.1004-4221.2012.03.004
Authors:CHEN Chuan-ben    PAN Jian-ji    CHEN Li-sha    BAI Peng-gang    LIN Shao-jun    ZHANG Yu    ZHANG Xiu-chun    FEI Zhao-dong
Affiliation:Department of Radiation Oncology, Tumor Hospital of Fujian Province, Teach Hospital of Fujian Medical University, Fuzhou 350014, ChinaCorresponding author:PAN Jian-ji, Email:panjianji@126.com
Abstract:Objective To analyze the correlation between primary tumor volume (PTV) and prognosis of nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT). Methods 330 NPC patients treated by IMRT were included. Pretreatment computerized tomography image were input into tree-dimensional treatment-planning system, in which the primary tumor volume were calculated automatically. The receiver operating characteristic curve was used to determine the best cut-off point of PTV. Within the framework of UICC 2002 T stage,The PTV was divided into four groups:V1<10 cm3, V2 10-25 cm3, V3>25-50 cm3 and V4>50 cm3. Kaplan-Meier and Logrank test was used to analyze the survival, Cox proportion risk regression model were used to analysis the correlation between PTV and prognosis. Results The mean PTV for all NPC patients was (34.2±27.1) cm3 with the range of 0.4-153.7 cm3. The 3-year overall survival for V1, V2, V3 and V4 stage were 88.6%,90.0%,91.2% and 74.2%, respectively (χ2=12.83,P=0.005). There was no significant difference among V1, V2 and V3 in terms of overall survival (χ2=1.96,P=0.376). The 3-year distant metastasis-free survival and diseases-free survival or overall survival were decrease in PTV>50 cm3 and PTV≤50 cm3 (77.4%∶89.9%, χ2=7.24, P=0.007and 64.5%∶85.1%, χ2=13.95,P=0.000 or 74.2%∶90.3%, χ2=11.76,P=0.001). Multivariate analysis revealed that PTV was a adverse prognostic factors for overall survival (χ2=0.00,P=2.580). Conclusion Our data showed that the primary tumor volume had significantly impacted on the prognosis of NPC patients treated by intensity modulated radiotherapy.
Keywords:Nasopharyngeal neoplasms/intensity-modulated radiotherapy  Planning target volume  Prognosis
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