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同步放化疗治疗的鼻咽癌患者按随访时间划分的肿瘤消退模式

Tumor regression patterns by follow-up duration in patients with nasopharyngeal carcinoma treated with concurrent chemoradiotherapy.

作者信息

Kong Moonkyoo, Hong Seong Eon

机构信息

Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, 23 Kyungheedae-gil, Dongdaemoon-gu, Seoul 130-702, Republic of Korea.

出版信息

J Radiat Res. 2017 Mar 1;58(2):232-237. doi: 10.1093/jrr/rrw100.

Abstract

The aim of this study was to describe the patterns of tumor regression with respect to follow-up duration after chemoradiotherapy in patients with nasopharyngeal carcinoma. A total of 27 patients with nasopharyngeal carcinoma were included and received definitive concurrent chemoradiotherapy. Patterns of primary tumor regression and development of locoregional recurrences were evaluated by imaging studies every 1 to 2 months. Primary tumors gradually regressed over the period of follow-up. The median time to full regression was 4.9 months (range, 1.5-19.4). In 61.5% of patients, the primary tumor continued to regress for >4 months after completion of chemoradiotherapy. Six patients experienced locoregional recurrence during follow-up, all of which occurred after full regression of the primary tumor. A patient group with delayed regression did not have poorer prognosis than a patient group with early regression. Older age, non-current-smoker status, advanced T stage, and higher daily radiation dose were significantly associated with delayed primary tumor regression. Nasopharyngeal carcinoma continued to regress for >4 months after chemoradiotherapy in a considerable number of patients. We recommend waiting for >4 months for full regression of nasopharyngeal carcinomas after chemoradiotherapy, if signs of persistent or recurrent disease are not evident on follow-up examination.

摘要

本研究的目的是描述鼻咽癌患者放化疗后肿瘤消退模式与随访时间的关系。共纳入27例鼻咽癌患者并接受了根治性同步放化疗。每1至2个月通过影像学检查评估原发肿瘤的消退模式和局部区域复发情况。在随访期间,原发肿瘤逐渐消退。完全消退的中位时间为4.9个月(范围1.5 - 19.4个月)。61.5%的患者在放化疗结束后原发肿瘤持续消退超过4个月。6例患者在随访期间出现局部区域复发,均发生在原发肿瘤完全消退之后。肿瘤消退延迟组患者的预后并不比肿瘤消退早的患者组差。年龄较大、非当前吸烟者、T分期较晚以及每日放疗剂量较高与原发肿瘤消退延迟显著相关。相当一部分患者在放化疗后鼻咽癌持续消退超过4个月。如果随访检查未发现持续或复发疾病的迹象,我们建议在放化疗后等待超过4个月以实现鼻咽癌的完全消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1887/5571611/ef1715a63144/rrw100f01.jpg

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