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比较改变分割与常规分割放疗联合同期化疗治疗晚期鼻咽癌的临床结果。

Comparison the clinical outcomes with altered versus conventional fractionated radiotherapy plus concurrent chemotherapy for advanced nasopharyngeal carcinoma.

机构信息

Department of Radiation Oncology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.

Department of Otorhinolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Head Neck. 2018 Jun;40(6):1156-1163. doi: 10.1002/hed.25084. Epub 2018 Feb 1.

Abstract

BACKGROUND

The purpose of this study was to compare the long-term survivals between altered fractionated and conventional fractionated radiotherapy with the same concurrent chemoradiotherapy (concurrent CRT) for patients with advanced nasopharyngeal carcinoma (NPC).

METHODS

We retrospectively reviewed 203 patients with NPC who received radiotherapy (RT) by either a conventional fractionated (70-74 Gy/35-37 fractions/7-8 weeks) or altered fractionated (72-75 Gy/45 fractions/6 weeks) schedule plus the same concurrent CRT.

RESULTS

The patient characteristics between conventional fractionated and altered fractionated groups showed similar distribution. The 5-year rates of nasopharyngeal failure-free, neck failure-free, and distant metastasis failure-free survival between conventional fractionated and altered fractionated groups were 88% versus 86% (P = .7781), 95% versus 93% (P = .4176), and 76% versus 73% (P = .4029), respectively. The overall survival (OS; 5-year rates were 64% versus 62%; P = .4812) and progression-free survival (PFS; 5-year rates were 67% versus 63%; P = .3829) rates also showed no significant differences. The acute and late toxicities were similar between both groups.

CONCLUSION

Altered fractionated and conventional fractionated RT achieved similar survival outcome when concurrent CRT strategy was used for advanced NPC.

摘要

背景

本研究旨在比较采用相同同期放化疗(concurrent CRT)的改良分割与常规分割放疗在晚期鼻咽癌(nasopharyngeal carcinoma, NPC)患者中的长期生存情况。

方法

我们回顾性分析了 203 例接受放疗(RT)的 NPC 患者,这些患者分别接受常规分割(70-74 Gy/35-37 次/7-8 周)或改良分割(72-75 Gy/45 次/6 周)方案加相同同期 CRT。

结果

常规分割组和改良分割组的患者特征分布相似。常规分割组和改良分割组的无鼻咽失败、无颈部失败和无远处转移失败的 5 年生存率分别为 88%对 86%(P = .7781)、95%对 93%(P = .4176)和 76%对 73%(P = .4029)。总生存(overall survival, OS; 5 年生存率为 64%对 62%; P = .4812)和无进展生存(progression-free survival, PFS; 5 年生存率为 67%对 63%; P = .3829)率也无显著差异。两组的急性和晚期毒性相似。

结论

在采用同期 CRT 策略治疗晚期 NPC 时,改良分割与常规分割 RT 可获得相似的生存结果。

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