Cao Cai-neng, Luo Jing-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.
PLoS One. 2015 Mar 6;10(3):e0119101. doi: 10.1371/journal.pone.0119101. eCollection 2015.
To evaluate concurrent chemotherapy for T4 classification nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).
From July 2004 to June 2011, 180 non-metastatic T4 classification NPC patients were retrospectively analyzed. Of these patients, 117 patients were treated by concurrent chemoradiotherapy (CCRT) using IMRT and 63 cases were treated by IMRT alone.
The median follow-up time was 58.97 months (range, 2.79-114.92) months. For all the patients, the 1, 3 and 5-year local failure-free survival (LFFS) rates were 97.7%, 89.2% and 85.9%, regional failure free survival (RFFS) rates were 98.9%, 94.4% and 94.4%, distant failure-free survival (DFFS) rates were 89.7%, 79.9% and 76.2%, and overall survival (OS) rates were 92.7%, 78.9% and 65.3%, respectively. No statistically significant difference was observed in LFFS, RFFS, DFFS and OS between the CCRT group and the IMRT alone group. No statistically significant difference was observed in acute toxicity except leukopenia (p = 0.000) during IMRT between the CCRT group and the IMRT alone group.
IMRT alone for T4 classification NPC achieved similar treatment outcomes in terms of disease local control and overall survival as compared to concurrent chemotherapy plus IMRT. However, this is a retrospective study with a limited number of patients, such results need further investigation in a prospective randomized clinical trial.
评估调强放射治疗（IMRT）联合化疗治疗T4期鼻咽癌（NPC）的疗效。
回顾性分析2004年7月至2011年6月期间180例非转移性T4期NPC患者。其中，117例患者接受IMRT同步放化疗（CCRT），63例患者仅接受IMRT治疗。
中位随访时间为58.97个月（范围2.79 - 114.92个月）。所有患者的1年、3年和5年局部无复发生存率（LFFS）分别为97.7%、89.2%和85.9%，区域无复发生存率（RFFS）分别为98.9%、94.4%和94.4%，远处无复发生存率（DFFS）分别为89.7%、79.9%和76.2%，总生存率（OS）分别为92.7%、78.9%和65.3%。CCRT组和单纯IMRT组在LFFS、RFFS、DFFS和OS方面未观察到统计学显著差异。CCRT组和单纯IMRT组在IMRT期间除白细胞减少（p = 0.000）外的急性毒性方面未观察到统计学显著差异。
与同步化疗加IMRT相比，单纯IMRT治疗T4期NPC在疾病局部控制和总生存方面取得了相似的治疗效果。然而，这是一项患者数量有限的回顾性研究，此类结果需要在前瞻性随机临床试验中进一步研究。
