Zhong Qiulu, Zhu Xiaodong, Li Ling, Qu Song, Liang Zhongguo, Zeng Fanyan, Pan Xinbin
Department of Radiation Oncology, The Affiliated Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Oncotarget. 2017 Jun 13;8(24):39683-39694. doi: 10.18632/oncotarget.14799.
To evaluate the efficacy of IMRT combined with concurrent chemotherapy followed by adjuvant chemotherapy compared with IMRT combined with concurrent chemotherapy alone in patients with nasopharyngeal carcinoma.
From January 2007 to December 2014, we collected 797 staged II-IVb [UICC = Union for International Cancer Control criteria (7th edition)] NPC patients for analysis. After 1:1 matching ,we selected 261 cases as the CCRT group, another 261 patients as the CCRT+AC group. Using Kaplan-Meier to calculate the overall survival (OS), locoregional failure-free survival(LFFS), distant metastasis failure-free survival(DMFS). The log-rank test and Cox-proportional hazards model to evaluate the prognostic factors.
After matching, there were 261 patients in each group. In CCRT+AC group, The 1-,2- and 3- year os rates were a little higher than in CCRT group(99.6% vs 97.9%,97.4% vs 96.2%,93.8% vs 86.9%, P = 0.150). There were no significant difference in 1-,2-,3- year OS, LFFS, DMFS between the two groups. In subgroup analysis, a little higher OS rate in CCRT+AC group for staged III, IV and T4(III:100% vs 100%, 97.6% vs 95.8%, 94.0% vs 84.0%; IV: 99.1% vs 95.4%, 96.3% vs 95.4%, 90.5% vs 79.4%, P = 0.047;T4:99.1% vs 95.2%, 97.1% vs 95.2%, 90.9% vs 78.2%, P = 0.055). No significant difference were observed in OS, LFFS,DMFS between the groups.
IMRT combined with concurrent chemotherapy followed by adjuvant chemotherapy might improved 1-,2-,3- year of OS. Whether or not add adjuvant chemotherapy it had similar LFFS rate and DMFS rate in patients with nasopharyngeal carcinoma. Locally advanced NPC patients (III, IV and T4)might benefit from the adjuvant chemotherapy.
评估调强适形放疗（IMRT）联合同步化疗后序贯辅助化疗与单纯IMRT联合同步化疗相比，在鼻咽癌患者中的疗效。
收集2007年1月至2014年12月期间797例II-IVb期[国际癌症控制联盟（UICC）标准（第7版）]鼻咽癌患者进行分析。经1:1匹配后，选取261例患者作为CCRT组，另261例患者作为CCRT+AC组。采用Kaplan-Meier法计算总生存期（OS）、局部区域无复发生存期（LFFS）、远处转移无复发生存期（DMFS）。采用对数秩检验和Cox比例风险模型评估预后因素。
匹配后，每组各有261例患者。CCRT+AC组1年、2年和3年总生存率略高于CCRT组（99.6%对97.9%，97.4%对96.2%，93.8%对86.9%，P = 0.150）。两组1年、2年、3年的总生存期、局部区域无复发生存期、远处转移无复发生存期差异均无统计学意义。亚组分析显示，CCRT+AC组III期、IV期和T4期患者的总生存率略高（III期：100%对100%，97.6%对95.8%，94.0%对84.0%；IV期：99.1%对95.4%，96.3%对95.4%，90.5%对79.4%，P = 0.047；T4期：99.1%对95.2%，97.1%对95.2%，90.9%对78.2%，P = 0.055）。两组间总生存期、局部区域无复发生存期、远处转移无复发生存期差异均无统计学意义。
IMRT联合同步化疗后序贯辅助化疗可能提高鼻咽癌患者1年、2年、3年总生存率。无论是否加用辅助化疗，鼻咽癌患者的局部区域无复发生存率和远处转移无复发生存率相似。局部晚期鼻咽癌患者（III期、IV期和T4期）可能从辅助化疗中获益。
