调强放疗鼻咽癌患者肿瘤体积的预后意义。
Prognostic significance of tumor volume in patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy.
机构信息
Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou, China.
出版信息
Head Neck. 2013 May;35(5):689-94. doi: 10.1002/hed.23010. Epub 2012 Jun 19.
BACKGROUND
This study was undertaken to analyze the correlation between primary gross tumor volume (GTVp) and prognosis in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiation therapy (IMRT).
METHODS
Between February 2001 and December 2006, 305 patients with NPC treated with IMRT were analyzed retrospectively. GTVp was calculated from treatment planning CT scans.
RESULTS
Univariate and multivariate analyses indicated that GTVp had a statistically significant correlation to local control, distant metastasis, and overall survival in patients with NPC, whereas T classification was not an independent prognostic factor. Among patients classified with N0-1 and N2-3, there were significant differences in the rates of distant metastasis between those with GTVp smaller and larger than 25 mL (p < .001 and p = .002, respectively).
CONCLUSIONS
GTVp is highly significant in evaluating local control, distant metastasis, and overall survival of patients with NPC treated with IMRT. Therefore, it is recommended that GTVp be included in the new TNM classification system.
背景
本研究旨在分析调强放疗（IMRT）治疗的鼻咽癌（NPC）患者原发肿瘤大体体积（GTVp）与预后的相关性。
方法
回顾性分析了 2001 年 2 月至 2006 年 12 月接受 IMRT 治疗的 305 例 NPC 患者。GTVp 是根据治疗计划 CT 扫描计算得出的。
结果
单因素和多因素分析表明，GTVp 与 NPC 患者的局部控制、远处转移和总生存率有统计学显著相关性，而 T 分类不是独立的预后因素。在 N0-1 和 N2-3 分类的患者中，GTVp 小于和大于 25mL 的患者远处转移率有显著差异（p＜.001 和 p=.002）。
结论
GTVp 在评价 IMRT 治疗的 NPC 患者的局部控制、远处转移和总生存率方面具有重要意义。因此，建议将 GTVp 纳入新的 TNM 分类系统。
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