Department of Radiation Oncology, The Affiliated Tumour Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 He Di Road, Nanning 530021, P.R. China.
Sci Rep. 2017 Feb 2;7:41449. doi: 10.1038/srep41449.
The present study aimed to define high-risk patients who may benefit from additional adjuvant chemotherapy (AC) after concurrent chemotherapy in combination with intensity-modulated radiotherapy among patients with loco-regionally advanced nasopharyngeal carcinoma (NPC). A cohort of 511 NPC patients who received concomitant chemoradiotherapy (CCRT) with or without AC between January 2007 and December 2012 were retrospectively analysed. One hundred seventy-seven patients received CCRT alone, whereas 334 received CCRT + AC. The survival analysis showed that ages >45 years old, T3-T4 stages, N2-N3 disease and serum albumin levels ≤42 g/L were significant independent prognostic factors for overall survival (OS). Using these four risk factors, a prognostic model for OS was created as follows: (1) low-risk group: 0-1 risk factors; and (2) high-risk group: 2-4 risk factors. In the CCRT alone and CCRT + AC groups, significant differences in survival were found between the high- and low-risk groups. Patients in the high-risk group exhibited improved OS due to the addition of AC to CCRT, but no survival benefits were found in the low-risk group. In conclusion, high-risk patients may benefit from the addition of AC to CCRT regarding OS.
本研究旨在确定局部晚期鼻咽癌（NPC）患者在同步放化疗（CCRT）后，哪些高危患者可能从辅助化疗（AC）中获益。回顾性分析了 2007 年 1 月至 2012 年 12 月期间接受单纯 CCRT 或 CCRT+AC 治疗的 511 例 NPC 患者。177 例患者接受单纯 CCRT，334 例患者接受 CCRT+AC。生存分析显示，年龄>45 岁、T3-T4 期、N2-N3 期疾病和血清白蛋白水平≤42g/L 是总生存（OS）的显著独立预后因素。使用这四个危险因素，建立了 OS 的预后模型如下：（1）低危组：0-1 个危险因素；（2）高危组：2-4 个危险因素。在单纯 CCRT 和 CCRT+AC 组中，高危组和低危组之间的生存存在显著差异。高危组患者因 CCRT 加用 AC 而 OS 得到改善，但低危组患者未发现生存获益。总之，高危患者可能从 CCRT 加用 AC 中获益。
