Long-term outcomes of patients with nasopharyngeal carcinoma in different stages treated by intensity-modulated radiotherapy and their treatment strategies
10.3760/cma.j.issn.1004-4221.2014.04.008
- VernacularTitle:不同亚组鼻咽癌调强放疗等的远期临床转归与治疗策略
- Author:
Shengfa SU
;
Chong ZHAO
;
Fei HAN
;
Chunyan CHEN
;
Weiwei XIAO
;
Xueming SUN
;
Taixiang LU
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal neoplasms/ intensity-modulated radiotherapy;
Prognosis;
Stratification analysis
- From:
Chinese Journal of Radiation Oncology
2013;(4):291-294
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the long-term outcomes of patients with nasopharyngeal carcinoma (NPC) in different stages treated by intensity-modulated radiotherapy (IMRT) and explore their treatment strategies.Methods A retrospective analysis was performed on the clinical data of 868 NPC patients without distant metastasis who received radical IMRT from May 2001 to October 2008.These patients were divided into early N0 (T1-2N0) group (n =137),early N1 (T1-2N1) group (n =129),locally advanced (T3-4N0-1) group (n =322),regionally advanced (T1-2 N2-3) group (n=107),and locoregionally advanced (T3-4 N2-3) group (n =173).There groups were compared in terms of treatment outcome and treatment strategy.Results The follow-up rate was 91.4％,and 314 patients completed 5-years follow-up.The 5-year overall survival rate,local recurrence-free rate,and distant metastasis-free rate (DMFR) were 83.5％,91.8％,and 84.6％,respectively.The early N0 group had the best treatment outcome,with a 5-year disease-specific survival (DSS) rate up to 99.1％.Each group had a similar outcome after receiving either IMRT alone or IMRT combined with chemotherapy.The locally advanced group and regionally advanced group had similar failure patterns and treatment outcomes.The locoregionally advanced group had the worst treatment outcome,with a 5-year DMFR of 67.2％ and a DSS of 68.0％.The regionally advanced group and locoregionally advanced group had a similar treatment outcome after receiving IMRT alone,induction chemotherapy plus IMRT,or concurrent chemotherapy and IMRT.Conclusions Patients with NPC in different stages have different survival outcomes.It is recommended that different treatment strategies should be adopted according to the T and N stages of NPC.IMRT alone can produce satisfactory results in patients with T1-2N0 NPC,but a more effective medication should be added to IMRT in patients with advanced NPC,particularly those with T3-4N2-3 NPC who have a relatively low DMFR.
