Analysis of the therapeutic effects of different treatmen t modalities on the outcomes of 87 patients ;with lung oligometastasis from nasopharyngeal carcinoma after radiotherapy
10.3760/cma.j.issn.0253-3766.2016.03.011
- VernacularTitle:不同方式治疗87例鼻咽癌放疗后肺寡转移患者的疗效分析
- Author:
Qiu TANG
1
;
Qiaoying HU
;
Yongfeng PIAO
;
Yonghong HUA
;
Xiaozhong CHEN
Author Information
1. 浙江省肿瘤医院头颈放疗科
- Keywords:
Nasopharyngeal neoplasms;
Neoplasms metastasis,lung;
Treatment;
Prognosis
- From:
Chinese Journal of Oncology
2016;38(3):218-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma ( NPC) after radiotherapy and to identify a more appropriate treatment modality.Methods The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively.Among them, 33 patients underwent local small-field irradiation+/-chemotherapy, 28 underwent whole-lung irradiation+chemotherapy, and 26 underwent simple chemotherapy.The survival rates were calculated using Kaplan-Meier analysis.The differences among the modalities were evaluated using the log-rank test.Cox univariate and multivariate analyses were performed to determine the influencing factors.Results The 3-year lung metastasis survival ( LMS) rates of patients with lung metastasis undergoing the three treatment modalities ( local small-field irradiation +/-chemotherapy, whole-lung irradiation+chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups ( P=0.003 ) .Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+/-chemotherapy group than that in the whole-lung irradiation+chemotherapy group and chemotherapy alone group (P=0.001).The 2y-ear progression -free survival (PFS ) rates of the three groups were 571.%, 25.8%and 3.8%, respectively, showing significant intergroup differences ( P=0.002 and P<0 .001 ) . Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+/-chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Conclusion Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.
