Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China.
Head Neck. 2019 Oct;41(10):3661-3669. doi: 10.1002/hed.25892. Epub 2019 Jul 27.
This study evaluates the contemporary care for patients with locally recurrent nasopharyngeal carcinoma after failure of the primary course of intensity modulated radiotherapy.
Eligible patients were identified through the Hong Kong Cancer Registry database. Patterns of care and treatment outcomes were analyzed.
Two hundred seventy-two patients with locally recurrent tumors were identified. Of them, 30.9% received surgery, whereas 35.7% received re-irradiation (re-RT). The 5-year overall survival (OS) for the whole group was 30.2%. Old age and advanced rT classification were adverse prognostic factors, whereas surgery (mainly in resectable recurrence) was associated with favorable survival outcome. The 5-year OS rates for patients who received surgery and re-RT were 56.3% and 21.8%, respectively.
Early detection of resectable recurrence is of paramount importance as surgery for resectable tumors offers the potential to achieve excellent outcomes. Re-RT could be considered in selected patients with unresectable disease and favorable prognostic features.
本研究评估了调强放疗失败后局部复发性鼻咽癌患者的当代治疗情况。
通过香港癌症登记数据库确定符合条件的患者。分析了治疗模式和治疗结果。
共确定了 272 例局部复发性肿瘤患者。其中，30.9%的患者接受了手术，35.7%的患者接受了再放疗（re-RT）。全组患者的 5 年总生存率（OS）为 30.2%。年龄较大和 rT 分类较晚是不良预后因素，而手术（主要是在可切除的复发中）与良好的生存结果相关。接受手术和 re-RT 的患者的 5 年 OS 率分别为 56.3%和 21.8%。
早期发现可切除的复发至关重要，因为手术切除肿瘤有获得良好效果的潜力。对于不可切除疾病和具有良好预后特征的患者，可以考虑 re-RT。
