Zeng Lei, Sun Xue-Ming, Chen Chun-Yan, Han Fei, Huang Ying, Xiao Wei-Wei, Liu Shuai, Tian Yun-Ming, Deng Xiao-Wu, Lu Tai-Xiang
State Key Laboratory Oncology in Southern China, Guangzhou, People's Republic of China; Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, People's Republic of China.
Head Neck. 2014 May;36(5):687-93. doi: 10.1002/hed.23359. Epub 2013 Oct 17.
The purpose of this study was to investigate the prophylactic irradiation volume to neck drainage areas for patients with N0 classification nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).
From January 2003 to October 2008, 270 patients with N0 classification (American Joint Committee on Cancer [AJCC] 2002 staging system) NPC who had undergone IMRT were retrospectively analyzed. Among all the patients, 171 patients received prophylactic upper-neck irradiation, and 99 patients received prophylactic whole-neck irradiation.
At a median follow-up of 65.1 months (range, 4-106 months). The 5-year overall survival (OS), nodal recurrence-free survival (NRFS), and distant metastasis-free survival (DMFS) rates of the upper neck group and the whole neck group were 93.6% vs 90.9% (p = .553), 99.4% vs 99.0% (p = .278), and 98.8% vs 94.9% (p = .128), respectively. A total of 3 neck recurrences were found, including 2 from the whole neck group and 1 from the upper neck group. The latter (0.6%) was an out-of-field recurrence.
Prophylactic irradiation to the upper neck (levels II, III, and VA) may be feasible for patients with neck lymph node-negative NPC.
本研究旨在探讨调强放疗（IMRT）治疗N0期鼻咽癌（NPC）患者颈部引流区的预防性照射范围。
回顾性分析2003年1月至2008年10月期间接受IMRT治疗的270例N0期（美国癌症联合委员会[AJCC]2002分期系统）NPC患者。所有患者中，171例接受了上颈部预防性照射，99例接受了全颈部预防性照射。
中位随访65.1个月（范围4 - 106个月）。上颈部组和全颈部组的5年总生存率（OS）、无区域淋巴结复发生存率（NRFS）和无远处转移生存率（DMFS）分别为93.6%对90.9%（p = 0.553）、99.4%对99.0%（p = 0.278）和98.8%对94.9%（p = 0.128）。共发现3例颈部复发，其中全颈部组2例，上颈部组1例。后者（0.6%）为野外复发。
对于颈部淋巴结阴性的NPC患者，对上颈部（II、III和VA区）进行预防性照射可能是可行的。
