Department of Medical Oncology, Habib Bourguiba Hospital, 37967University of Sfax, Sfax, Tunisia.
Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba Hospital, 37967University of Sfax, Sfax, Tunisia.
Ear Nose Throat J. 2021 Sep;100(5_suppl):795S-800S. doi: 10.1177/0145561320908955. Epub 2020 Mar 6.
The study aimed to investigate the epidemiological and clinical characteristics as well as the therapeutic results in patients with locoregional (LR) relapse after treatment of nasopharyngeal carcinoma (NPC).
We retrospectively reviewed the medical records of patients with local and/or regional recurrent NPC over 13 years (2003-2015).
Twenty-five patients were treated for local or/and local-regional recurrence of NPC. The rate of LR relapse was 7.2%. The mean age of the patients was 46 ± 13.9 years. The median time to relapse was 25 months. The recurrence was nasopharyngeal in 17 patients, nasopharyngeal and neck lymph nodes in 7 patients, and neck lymph nodes in 1 patient. Fifteen relapsed patients had a locally advanced disease (rT3-rT4). Patients who had initially T1 or T2 tumor had a locally advanced relapsed disease (rT3rT4) in 27.3% and patients whose disease was initially classified as T3 or T4 had a locally advanced relapsed disease (rT3T4) in 85.7% ( = .005, Fisher test). Twelve patients had chemotherapy after relapse. Chemotherapy was followed by concurrent chemoradiotherapy in 3 patients and by radiotherapy (RT) in 4 patients. Nine patients had concurrent chemoradiotherapy and 1 patient had exclusive RT. The overall survival (OS) at 1 year, 3 years, and 5 years was, respectively, 58%, 18%, and 10%. The OS was significantly higher in patients with good performance status at the time of relapse (World Health Organization = 1; = .01) and in patients with late relapse (after 2 years; = .03).
Locoregional relapse rate in our study was 7.2%. Locoregional reirradiation was the mainstay treatment modality in relapsed NPC. Relapsed NPC had a poor prognosis with a 5-year survival rate of 18%. The OS was significantly higher in patients with good performance status and in patients with late relapse (after 2 years).
本研究旨在探讨治疗鼻咽癌（NPC）后局部区域（LR）复发患者的流行病学和临床特征以及治疗效果。
我们回顾性分析了 13 年来（2003-2015 年）局部和/或局部区域复发性 NPC 患者的病历。
25 例患者因 NPC 局部或/和局部区域复发而接受治疗。LR 复发率为 7.2%。患者的平均年龄为 46 ± 13.9 岁。中位复发时间为 25 个月。17 例患者复发于鼻咽部，7 例患者复发于鼻咽部和颈部淋巴结，1 例患者复发于颈部淋巴结。15 例复发患者为局部晚期疾病（rT3-rT4）。最初肿瘤为 T1 或 T2 期的患者中有 27.3%出现局部晚期复发疾病（rT3rT4），最初疾病分类为 T3 或 T4 的患者中有 85.7%出现局部晚期复发疾病（rT3T4）（ =.005，Fisher 检验）。12 例患者在复发后接受了化疗。化疗后，3 例患者接受同期放化疗，4 例患者接受放疗（RT）。9 例患者接受同期放化疗，1 例患者接受单纯 RT。1 年、3 年和 5 年的总生存率（OS）分别为 58%、18%和 10%。复发时表现状态良好的患者（世界卫生组织=1；=.01）和复发时间较晚（2 年后；=.03）的患者 OS 明显更高。
本研究中局部区域复发率为 7.2%。局部区域再放疗是复发性 NPC 的主要治疗方式。复发性 NPC 预后较差，5 年生存率为 18%。表现状态良好和复发时间较晚（2 年后）的患者 OS 明显更高。
