Chua Daniel T T, Sham Jonathan S T, Kwong Dora L W, Au Gordon K H
Department of Clinical Oncology, the University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
Cancer. 2003 Jul 1;98(1):74-80. doi: 10.1002/cncr.11485.
The objective of this study was to review the long-term treatment outcome of patients with American Joint Committee on Cancer (AJCC) 1997 Stage I-II nasopharyngeal carcinoma (NPC) who were treated with radiotherapy alone.
One hundred forty-one patients with NPC had AJCC 1997 Stage I-II disease (Stage I NPC, 50 patients; Stage II NPC, 91 patients) after restaging and were treated with radiotherapy alone between September 1989 and August 1991. Fifty-seven patients had lymph node disease, and the median greatest lymph node dimension was 3 cm. The median dose to the nasopharynx was 65 grays. The median follow-up was 82 months (range, 4-141 months).
Patients who had Stage I disease had an excellent outcome after radiotherapy. The 10-year disease specific survival, recurrence free survival (RFS), local RFS, lymph node RFS, and distant metastasis free survival rates were 98%, 94%, 96%, 98%, and 98%, respectively. Patients who had Stage II disease had a worse outcome compared with patients who had Stage I disease: The corresponding 10-year survival rates were 60%, 51%, 78%, 93%, and 64%. The differences all were significant except for lymph node control. Among patients who had Stage II disease, those with T1-T2N1 NPC appeared to have a worse outcome compared with patients who had T2N0 NPC. No significant differences in survival rates were found with respect to lymph node size or status for patients with T1-T2N1 disease.
When patients with NPC had their disease staged according to the AJCC 1997 classification system, patients with Stage I disease had an excellent outcome after they were treated with radiotherapy alone. Patients with Stage II disease, especially those with T1-T2N1 disease, had a relatively worse outcome, and more aggressive therapy, such as combined-modality treatment, may be indicated for those patients.
本研究的目的是回顾仅接受放射治疗的美国癌症联合委员会（AJCC）1997年I-II期鼻咽癌（NPC）患者的长期治疗结果。
141例NPC患者在重新分期后为AJCC 1997年I-II期疾病（I期NPC患者50例；II期NPC患者91例），于1989年9月至1991年8月仅接受放射治疗。57例患者有淋巴结疾病，最大淋巴结直径中位数为3 cm。鼻咽部的中位剂量为65格雷。中位随访时间为82个月（范围4 - 141个月）。
I期疾病患者放射治疗后预后良好。10年疾病特异性生存率、无复发生存率（RFS）、局部RFS、淋巴结RFS和无远处转移生存率分别为98%、94%、96%、98%和98%。II期疾病患者与I期疾病患者相比预后较差：相应的10年生存率分别为60%、51%、78%、93%和64%。除淋巴结控制外，所有差异均具有显著性。在II期疾病患者中，T1 - T2N1 NPC患者与T2N0 NPC患者相比预后似乎更差。T1 - T2N1疾病患者的生存率在淋巴结大小或状态方面未发现显著差异。
当NPC患者按照AJCC 1997分类系统分期时，I期疾病患者仅接受放射治疗后预后良好。II期疾病患者，尤其是T1 - T2N1疾病患者，预后相对较差，对于这些患者可能需要更积极的治疗，如综合治疗。
