采用调强放疗的低剂量或高剂量同期放化疗治疗晚期鼻咽癌：一项倾向评分匹配的全国性基于人群的队列研究。
Treatment of advanced nasopharyngeal cancer using low- or high-dose concurrent chemoradiotherapy with intensity-modulated radiotherapy: A propensity score-matched, nationwide, population-based cohort study.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan.
Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taiwan.
出版信息
Radiother Oncol. 2018 Oct;129(1):23-29. doi: 10.1016/j.radonc.2017.12.004. Epub 2017 Dec 22.
BACKGROUND
No large-scale, head-to-head, phase III, randomized, controlled trial with an adequate sample size has investigated the effect of concurrent low-dose (LD) or high-dose (HD) cisplatin with radiotherapy on nasopharyngeal cancer (NPC). Thus, we conducted a propensity-score-matched, nationwide, population-based cohort study in Taiwan to investigate the outcomes of LD-concurrent chemoradiotherapy (CCRT) or HD-CCRT with intensity-modulated radiotherapy (IMRT) in patients with advanced NPC.
METHODS
In this study, patients were categorized into 2 groups according to their chemotherapy regimen: HD-CCRT and LD-CCRT groups.
RESULTS
We enrolled 1968 patients (328 and 1640 in the LD-CCRT and HD-CCRT groups, respectively) who had received CCRT with IMRT. According to both univariate and multivariate Cox regression analyses, a hazard ratio (95% confidence interval) of 0.75 (0.54-1.06, P = .103) was derived for the HD-CCRT group.
CONCLUSION
LD-CCRT or HD-CCRT with IMRT can be a standard treatment that can prolong the survival of patients with advanced NPC.
背景
没有大规模、头对头、III 期、随机、对照试验，样本量充足，研究了低剂量（LD）或高剂量（HD）顺铂与放疗联合治疗鼻咽癌（NPC）的效果。因此，我们在台湾进行了一项倾向评分匹配的全国性基于人群的队列研究，以调查高强度调强放疗（IMRT）中 LD 同期放化疗（CCRT）或 HD-CCRT 对晚期 NPC 患者的疗效。
方法
在这项研究中，根据化疗方案将患者分为两组：HD-CCRT 组和 LD-CCRT 组。
结果
我们共纳入了 1968 名患者（LD-CCRT 组和 HD-CCRT 组分别为 328 名和 1640 名），他们均接受了 IMRT 下的 CCRT。根据单因素和多因素 Cox 回归分析，HD-CCRT 组的风险比（95%置信区间）为 0.75（0.54-1.06，P=0.103）。
结论
IMRT 下的 LD-CCRT 或 HD-CCRT 可以作为一种标准治疗方法，延长晚期 NPC 患者的生存时间。
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