Cao Cai-neng, Luo Jin-wei, Gao Li, Yi Jun-lin, Huang Xiao-dong, Wang Kai, Zhang Shi-ping, Qu Yuan, Li Su-yan, Xiao Jian-ping, Zhang Zhong, Xu Guo-zhen
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Oral Oncol. 2015 Feb;51(2):190-4. doi: 10.1016/j.oraloncology.2014.11.009. Epub 2014 Nov 26.
To evaluate the long-term survival outcomes and toxicity of a larger series of patients with non-metastatic T4 classification nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT).
From March 2004 to June 2011, 335 non-metastatic T4 classification NPC patients treated by IMRT were analyzed retrospectively. Treatment induced toxicities were scored according to the Common Terminology Criteria for Adverse Events version 3.0.
With a median follow-up time of 53.6 months (range, 2.8-114.9 months), the 5-year local failure-free survival (LFFS), regional failure free survival (RFFS), distant failure-free survival (DFFS), and overall survival (OS) were 84.1%, 92.2%, 74.1%, and 63.0%, respectively. At their last follow-up visit, 118 patients (35.2%) had developed treatment failure. Distant metastasis was the major failure pattern after treatment. The most common toxicities were mainly in grade 1 or 2. Concurrent chemotherapy failed to improve survival rates for patients with T4 classification NPC.
The results of T4 classification NPC treated by IMRT were excellent, and distant metastasis was the most commonly failure pattern. Treatment-related toxicities were well tolerable. The role of concurrent chemotherapy for T4 classification NPC needs to be further investigated in the era of IMRT.
评估接受调强放疗（IMRT）治疗的更大系列非转移性T4期鼻咽癌（NPC）患者的长期生存结局和毒性。
回顾性分析2004年3月至2011年6月期间接受IMRT治疗的335例非转移性T4期NPC患者。根据不良事件通用术语标准第3.0版对治疗引起的毒性进行评分。
中位随访时间为53.6个月（范围2.8 - 114.9个月），5年局部无失败生存率（LFFS）、区域无失败生存率（RFFS）、远处无失败生存率（DFFS）和总生存率（OS）分别为84.1%、92.2%、74.1%和63.0%。在最后一次随访时，118例患者（35.2%）出现治疗失败。远处转移是治疗后的主要失败模式。最常见的毒性主要为1级或2级。同步化疗未能提高T4期NPC患者的生存率。
IMRT治疗T4期NPC的结果良好，远处转移是最常见的失败模式。治疗相关毒性耐受性良好。在IMRT时代，同步化疗对T4期NPC的作用需要进一步研究。
