调强放疗时代原发肿瘤部位剂量不足的鼻咽癌预后。
Prognosis of nasopharyngeal carcinoma with insufficient radical dose to the primary site in the intensity-modulated radiotherapy era.
机构信息
Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fuzhou, China.
Department of Radiation Oncology, Fujian Cancer Hospital, Fuzhou, China.
出版信息
Head Neck. 2019 Oct;41(10):3516-3524. doi: 10.1002/hed.25865. Epub 2019 Jul 16.
BACKGROUND
It was reported that reduced radiotherapy is feasible for children with nasopharyngeal carcinoma (NPC) and papilloma virus-positive oropharyngeal cancer. Therefore, we performed this study to explore the prognosis of reduced-dose radiation in adult with NPC.
METHODS
Between 2004 and 2013, we retrospectively analyzed 19 patients histologically diagnosed with NPC, who received <66 Gy radiation therapy. Ten patients receiving <54 Gy to the primary site were group A. Nine patients receiving ≥54 Gy were group B.
RESULTS
Thirteen patients received induction chemotherapy (IC) for two or three cycles. In group A, the 5-year overall survival (OS) was 50.0%. For group B, the 5-year OS, locoregional relapse-free survival, progression-free survival, and distant metastasis-free survival were 88.9%, 100.0%, 88.9%, and 88.9%. Group B had a better prognosis than group A on OS (88.9% vs 50.0%, P = .03).
CONCLUSION
Patients receiving ≥54 Gy but <66 Gy with IC achieved good local control and long-term survival.
背景
有报道称，减少放疗剂量对于人乳头瘤病毒阳性的口咽癌和鼻咽癌患儿是可行的。因此，我们进行了这项研究，以探讨成人鼻咽癌接受低剂量放疗的预后。
方法
我们回顾性分析了 2004 年至 2013 年间 19 例经组织学诊断为 NPC 的患者，这些患者接受了<66Gy 的放射治疗。10 例原发灶接受<54Gy 照射的患者归入 A 组，9 例接受≥54Gy 照射的患者归入 B 组。
结果
13 例患者接受了两个或三个周期的诱导化疗。A 组中，5 年总生存率（OS）为 50.0%。B 组中，5 年 OS、无局部区域复发生存率、无进展生存率和无远处转移生存率分别为 88.9%、100.0%、88.9%和 88.9%。B 组的 OS 明显优于 A 组（88.9% vs 50.0%，P=0.03）。
结论
接受≥54Gy 但<66Gy 并联合 IC 的患者可获得良好的局部控制和长期生存。
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