Luo Shanquan, Zhao Lina, Wang Jianhua, Xu Man, Li Jianping, Zhou Bin, Xiao Feng, Long Xiaoli, Shi Mei
Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Head Neck. 2014 Jun;36(6):841-7. doi: 10.1002/hed.23386. Epub 2013 Oct 4.
The clinical outcomes for early-stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated.
A retrospective study was performed from 69 patients with NPC patients treated with intensity-modulated radiation therapy (IMRT) with or without chemotherapy.
Median follow-up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3-year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively (p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors (p < .05). No grade IV toxicities were observed.
T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported.
评估中国西北部早期鼻咽癌（NPC）的临床结局。
对69例接受调强放射治疗（IMRT）联合或不联合化疗的NPC患者进行回顾性研究。
中位随访时间为34个月。世界卫生组织（WHO）II型是主要的组织学类型（71%）。所有治疗失败均发生在T2N1期NPC患者中（14.5%），转移是主要原因。3年总生存率（OS）、无局部复发生存率（LRFS）和无远处转移生存率（DMFS）分别为93.3%、94.1%和94.8%。T2N1期和单纯IMRT组的3年生存率分别显著低于T1N0、T2N0和T1N1组以及放化疗组（p <.05）。N1分期、T2N1分期以及放化疗的联合是显著的独立预测因素（p <.05）。未观察到IV级毒性反应。
T2N1分期是远处转移风险较高的独特亚组。尚未有关于主要为WHO II型组织学的T2N1期NPC患者放化疗后改善结局的报道。
