诱导化疗联合同步放化疗治疗晚期鼻咽癌的长期疗效

[Long-term efficacy of induction chemotherapy plus concurrent radiochemotherapy on advanced nasopharyngeal carcinoma].

作者信息

Liang Ying, Gao Jian-Ming, Hu Wei-Han, Gao Yuan-Hong, Xie Fang-Yun

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, PR China.

出版信息

Ai Zheng. 2007 Aug;26(8):885-9.

PMID:17697553

Abstract

BACKGROUND & OBJECTIVE: Induction chemotherapy plus concurrent radiochemotherapy may prolong disease-free and overall survival of advanced nasopharyngeal carcinoma (NPC) patients. This study was to compare the long-term efficacy of induction chemotherapy plus concurrent radiochemotherapy and radiotherapy alone on advanced NPC.

METHODS

Clinical data of 535 advanced NPC patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1997 to Dec. 1998, were analyzed. Of the 535 patients, 75 were treated with 3-5 cycles of induction and concomitant chemotherapy of PF regimen (cisplatin combined 5-fluorouracil) plus radiotherapy, 460 were treated with radiotherapy alone. The survival statuses of the 2 groups were compared. Prognostic factors were analyzed by Cox regression analysis. Cumulative survival rate was analyzed by Kaplan-Meier method.

RESULTS

The 5-year overall and disease-free survival rates were significantly higher in radiochemotherapy group than in radiotherapy group (78.15% vs. 55.27%, 71.55% vs. 48.99%, P<0.05). For the patients with stage III tumors, the median overall and disease-free survival term were significantly longer in radiochemotherapy group than in radiotherapy group (94.5 months vs. 85.1 months, 89.5 months vs. 82.9 months, P<0.05). For the patients with stage IVa tumors, the same results were obtained (82.4 months vs. 44.4 months, 69.6 months vs. 40.3 months, P<0.05). Cox regression analysis showed that clinical stage and chemotherapy were dependent prognostic factors of advanced NPC.

CONCLUSION

Induction chemotherapy plus concurrent radiochemotherapy could prolong the survival of patients with advanced NPC.

摘要

背景与目的

诱导化疗联合同期放化疗可能延长晚期鼻咽癌（NPC）患者的无病生存期和总生存期。本研究旨在比较诱导化疗联合同期放化疗与单纯放疗对晚期NPC的长期疗效。

方法

分析1997年1月至1998年12月在中山大学肿瘤防治中心治疗的535例晚期NPC患者的临床资料。535例患者中，75例接受3 - 5周期PF方案（顺铂联合5 - 氟尿嘧啶）诱导及同步化疗加放疗，460例接受单纯放疗。比较两组的生存状况。采用Cox回归分析预后因素。采用Kaplan - Meier法分析累积生存率。

结果

放化疗组的5年总生存率和无病生存率显著高于放疗组（78.15%对55.27%，71.55%对48.99%，P<0.05）。对于Ⅲ期肿瘤患者，放化疗组的中位总生存期和无病生存期显著长于放疗组（94.5个月对85.1个月，89.5个月对82.9个月，P<0.05）。对于Ⅳa期肿瘤患者，也得到相同结果（82.4个月对44.4个月，69.6个月对40.3个月，P<0.05）。Cox回归分析显示，临床分期和化疗是晚期NPC的独立预后因素。