Prognostic factors of 305 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy
- VernacularTitle:305例鼻咽癌调强放疗预后因素分析
- Author:
Han LU
1
;
Lin SHAO-JUN
;
Pan JIAN-JI
;
Chen CHUAN-BEN
;
Zhang YU
;
Zhang XIU-CHUN
;
Liao XI-YI
;
Chen QI-SONG
Author Information
1. 福建医科大学教学医院
- Keywords:
Nasopharyngeal neoplasm;
radiotherapy;
intensity-modulated;
prognosis;
side effect
- From:Chinese Journal of Cancer
2010;29(2):153-158
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective:Radiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy,toxicity,and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment of NPC. Methods: Between September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian ProvinciaI Cancer Hospital.IMRT was delivered as follows:gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions.high-risk clinical target volume(CTV-1)received 60.0-66.65 Gy,low-risk clinical target volume(CTV/-21 and clinical target volume of cervical lymph node regions(CTV-N)received 54.0-55.8 Gy.Patients with stages Ⅲ or Ⅳ disease also received cisplatinbased chemotherapy.All patients were assessed for local-regional control,survival,and toxicity.Results:With a median follow-up of 35 months (range,5-61 months),there were 16,8,and 39 patients who had developed Iocal,regional, and distant recurrence, respectively.The 3-year rates of local controI.regional controI.metastasis--free survival,disease-free survival,and overall survival were 94.3%,97.7%,86.1%,80.3%,and 89.1%,respectively.Multivariate analyses revealed that T-classification had no predictive value for local control and survival,whereas N-classification was a significant prognostic factor for overall survival(P<0.001),metastasis-free survival(P<0.001),and disease.free survival(P=0.003).For stages Ⅲ-Ⅳ disease,concurrent and adjuvant chemotherapy did not influence prognosis.The most severe acute toxicities included Grade Ⅲ mucositis in 14 patients (4.6%),Grade Ⅲ skin desquamation in 90(29.5%),and Grades Ⅲ-Ⅳ leucocytopenia in 20(6.5%).There were 7% patients with Grade Ⅱ xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected.Conclusions:IMRT provided favorable locoregional control and survivaI rates for patients with NPC.even in those with locally advanced disease.The acute and late toxicities were acceptable. Nclassification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.
