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调强放疗后仅出现咽后淋巴结转移的鼻咽癌患者行颈部局部照射的治疗效果及可行性

Treatment outcomes and feasibility of partial neck irradiation for patients with nasopharyngeal carcinoma with only retropharyngeal lymph node metastasis after intensity-modulated radiotherapy.

作者信息

Chen Mo, Tang Ling-Long, Sun Ying, Mao Yan-Ping, Li Wen-Fei, Guo Rui, Liu Li-Zhi, Li Li, Lin Ai-Hua, Ma Jun

机构信息

Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

Head Neck. 2014 Apr;36(4):468-73. doi: 10.1002/hed.23314. Epub 2013 Jun 18.

Abstract

BACKGROUND

The purpose of this study was to summarize the treatment outcomes and evaluate the feasibility of partial neck irradiation in patients with nasopharyngeal carcinoma (NPC) with only retropharyngeal lymph nodes (RLNs) metastasis.

METHODS

Between January 2003 and December 2007, 54 patients with NPC who received partial neck irradiation to levels II, III, and VA and 100 patients who received whole neck irradiation were reviewed.

RESULTS

The 5-year disease free survival (DFS), disease metastasis-free survival, (DMFS) local relapse-free survival (LRFS), and regional relapse-free survival (RRFS) rates were 81.8%, 87.7%, 94.8%, and 98.1%, respectively. The 5-year RRFS and DFS rates for the partial neck irradiation group and whole neck irradiation group were 98.1% versus 98.0% (p = .882), 87.0% vs 77.0% (p = .117), respectively. Partial neck irradiation was not considered a significant prognostic factor for any endpoint in univariate and multivariate analyses.

CONCLUSION

Partial irradiation of neck levels II, III, and VA might be acceptable for patients with NPC with only RLN metastasis.

摘要

背景

本研究旨在总结仅伴有咽后淋巴结(RLNs)转移的鼻咽癌(NPC)患者的治疗结果,并评估颈部局部照射的可行性。

方法

回顾性分析2003年1月至2007年12月期间接受颈部II、III和VA区局部照射的54例NPC患者以及接受全颈照射的100例患者。

结果

5年无病生存率(DFS)、无疾病转移生存率(DMFS)、局部无复发生存率(LRFS)和区域无复发生存率(RRFS)分别为81.8%、87.7%、94.8%和98.1%。局部颈部照射组和全颈部照射组的5年RRFS和DFS率分别为98.1%对98.0%(p = 0.882)、87.0%对77.0%(p = 0.117)。在单因素和多因素分析中,局部颈部照射均未被视为任何终点的显著预后因素。

结论

对于仅伴有RLN转移的NPC患者,颈部II、III和VA区的局部照射可能是可以接受的。

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