Chen Kai-Hua, Zhu Xiao-Dong, Li Ling, Qu Song, Liang Zhen-Qiang, Liang Xia, Pan Xin-Bin, Liang Zhong-Guo, Jiang Yan-Ming
Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, Guangxi, China.
Oncotarget. 2016 Oct 18;7(42):69041-69050. doi: 10.18632/oncotarget.11978.
This study aimed to explore whether concurrent chemoradiotherapy (CCRT) with or without Adjuvant Chemotherapy (AC) could improved the survival in stage II nasopharyngeal carcinoma (NPC).
Patients with stage II NPC treated with CCRT (n=80) or CCRT+AC (n=40) or IMRT alone (n=42) between January 2007 and September 2014 were retrospectively analyzed. The three patient groups were matched based on prognostic factors. All patients were treated with IMRT. The endpoints were overall survival (OS), distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRRFS), and failure-free survival (FFS). The treatment-related acute toxicity reactions between the three groups were compared also.
The three groups indicated similar outcomes: survival of the CCRT group, CCRT+AC group and RT alone group were (93.9%, 95.0%, 95.2%, P=0.937) for OS, (96.8%, 94.9%, 93.0%, P=0.756) for LRRFS, (91.1%, 97.5%, 100%, P=0.185) for DMFS and (84.9%, 92.5%, 93.0%, P=0.597) for FFS. Both the univariate and multivariate analysis indicated that older age predicted lower LRRFS and FFS. The CCRT and CCRT+AC groups showed more acute toxicity reactions, especially in bone marrow suppression, Liver dysfunction, gastrointestinal reactions (nausea/vomiting) and weight loss.
CCRT with/without AC could not improve the survival conditions of patients with stage II NPC, but remarkably increased treatment-associated acute toxic reactions when compared with IMRT alone.
本研究旨在探讨同步放化疗（CCRT）联合或不联合辅助化疗（AC）是否能提高Ⅱ期鼻咽癌（NPC）患者的生存率。
回顾性分析2007年1月至2014年9月期间接受CCRT（n = 80）或CCRT + AC（n = 40）或单纯调强放疗（IMRT）（n = 42）治疗的Ⅱ期NPC患者。根据预后因素对三组患者进行匹配。所有患者均接受IMRT治疗。观察终点为总生存期（OS）、无远处转移生存期（DMFS）、无局部区域复发生存期（LRRFS）和无失败生存期（FFS）。同时比较三组之间与治疗相关的急性毒性反应。
三组的结果相似：CCRT组、CCRT + AC组和单纯放疗组的OS分别为（93.9%，95.0%，95.2%，P = 0.937），LRRFS分别为（96.8%，94.9%，93.0%，P = 0.756），DMFS分别为（91.1%，97.5%，100%，P = 0.185），FFS分别为（84.9%，92.5%，93.0%，P = 0.597）。单因素和多因素分析均表明，年龄较大预示着较低的LRRFS和FFS。CCRT组和CCRT + AC组表现出更多的急性毒性反应，尤其是在骨髓抑制、肝功能损害、胃肠道反应（恶心/呕吐）和体重减轻方面。
CCRT联合或不联合AC不能改善Ⅱ期NPC患者的生存状况，但与单纯IMRT相比，显著增加了与治疗相关的急性毒性反应。
