Role of intensity-modulated radiation therapy combined with chemotherapy in patients with stage T 1-2N 1M 0 nasopharyngeal carcinoma: a retrospective study
10.3760/cma.j.cn113030-20210412-00155
- VernacularTitle:调强放疗联合化疗在T 1-2N 1M 0期鼻咽癌患者中的作用回顾性研究
- Author:
Peijing LI
1
;
Ting JIN
;
Yuanyuan CHEN
;
Ming CHEN
;
Ye TIAN
Author Information
1. 苏州大学附属第二医院放射治疗科，苏州大学放射肿瘤治疗学研究所，苏州市肿瘤放射治疗学重点实验室 215004
- Keywords:
Nasopharyngeal neoplasm/intensity-modulated radiation therapy;
Nasopharyngeal neoplasm/adjuvant chemotherapy;
Induction chemotherapy;
Concurrent chemorad
- From:
Chinese Journal of Radiation Oncology
2021;30(12):1227-1232
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for treating patients with T 1-2N 1M 0 nasopharyngeal carcinoma (NPC). Methods:343 patients diagnosed with T 1-2N 1M 0 NPC in Zhejiang Cancer Hospital and Sun Yat-sen University Cancer Center from January 2008 to December 2016 were recruited in this study. All patients received IMRT and divided into the radiotherapy (RT) and chemoradiotherapy (CRT) groups. Patients in the CRT group were further assigned into the concurrent chemoradiotherapy (CCRT), induction chemotherapy+ CCRT (IC+ CCRT) and CCRT+ adjuvant chemotherapy (AC) groups. Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) were estimated by Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox models. Results:The median follow-up time for surviving patients (303/343) was 91(range: 49-138) months. The 5-year OS, CSS, PFS, LRFFS, and DMFS rates in the CRT group were not superior to those of the RT group (93.7%: 93.9%, 93.7%: 93.9%, 89.0%: 87.7%, 93.8%: 92.8%, 93.8%: 91.2%, all P>0.05). No significant difference was found in treatment outcomes of patients with T 1N 1 or T 2N 1 NPC between two groups (all P>0.05). In multivariable analyses, only age was an independent prognostic factor for OS, PFS, CSS and DMFS, and negative correlation was found between them. No survival benefits were achieved in the CCRT, IC+ CCRT, CCRT+ AC and RT groups, and no significant differences were found in clinical efficacy among the three combined (all P>0.05). Conclusions:IMRT alone yields comparable clinical efficacy to CRT in treating patients with T 1-2N 1M 0 NPC. However, whether CT can be eliminated in the T 1-2N 1M 0 population still needs further confirmation by prospective, randomized and controlled clinical trials.
