首次调强放射治疗工作日对鼻咽癌患者生存结局的影响：一项多中心队列研究。

Impact of the weekday of the first intensity-modulated radiotherapy treatment on the survival outcomes of patients with nasopharyngeal carcinoma: A multicenter cohort study.

作者信息

Mo Yunyan, Zhang Bin, Pan Yufei, Qin Qinghua, Ye Yaomin, Li Xi, Huang Liying, Jiang Wei

机构信息

Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, China.

Department of Radiation Oncology, Wuzhou Red Cross Hospital, Wuzhou 543002, China.

出版信息

Oral Oncol. 2021 May;116:105258. doi: 10.1016/j.oraloncology.2021.105258. Epub 2021 Mar 9.

DOI:10.1016/j.oraloncology.2021.105258

PMID:33706048

Abstract

BACKGROUND

This study's purpose was to assess whether the weekday on which intensity-modulated radiotherapy (IMRT) is initiated influences survival outcomes in patients with nasopharyngeal carcinoma (NPC).

MATERIALS AND METHODS

A total of 1440 patients with NPC who received IMRT were enrolled in this study between January 2010 and June 2016. The patients were divided into five groups according to the weekday of their first radiotherapy treatment. Group 1 (n = 322), Group 2 (n = 322), Group 3 (n = 286), Group 4 (n = 292) and Group 5 (n = 218) received first radiotherapy on Monday, Tuesday, Wednesday, Thursday and Friday respectively. Differences in the rates of overall survival (OS), disease-free survival (DFS), loco-regional relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) were compared among the five groups using the Kaplan-Meier method and Cox regression models.

RESULTS

No significant differences were found in OS, DFS, LRRFS or DMFS among the five groups. The Cox regression analysis showed that the weekday on which the radiotherapy was initiated was not an independent predictor of OS (Hazard Ratio [HR], 1.056; 95%CI: 0.959-1.164, P = 0.268), DFS (HR, 1.067; 95% CI: 0.980-1.161, P = 0.137), LRRFS (HR, 1.069; 95% CI: 0.914-1.249, P = 0.404) and DMFS (HR, 1.027; 95% CI: 0.929-1.134, P = 0.607). The subgroup analysis showed no significant differences among the five groups.

CONCLUSIONS

This study showed that the day of the week that patients with nasopharyngeal carcinoma begin radiotherapy has no effect on their survival outcomes.

摘要

背景

本研究旨在评估开始调强放射治疗（IMRT）的工作日是否会影响鼻咽癌（NPC）患者的生存结局。

材料与方法

2010年1月至2016年6月期间，共有1440例接受IMRT的NPC患者纳入本研究。根据首次放疗的工作日将患者分为五组。第1组（n = 322）、第2组（n = 322）、第3组（n = 286）、第4组（n = 292）和第5组（n = 218）分别于周一、周二、周三、周四和周五接受首次放疗。采用Kaplan-Meier法和Cox回归模型比较五组患者的总生存（OS）率、无病生存（DFS）率、局部区域无复发生存（LRRFS）率和远处转移无复发生存（DMFS）率。

结果

五组患者的OS、DFS、LRRFS或DMFS均无显著差异。Cox回归分析显示，开始放疗的工作日不是OS（风险比[HR]，1.056；95%置信区间：0.959 - 1.164，P = 0.268）、DFS（HR，1.067；95%置信区间：0.980 - 1.161，P = 0.137）、LRRFS（HR，1.069；95%置信区间：0.914 - 1.249，P = 0.404）和DMFS（HR，1.027；95%置信区间：0.929 - 1.134，P = 0.607）的独立预测因素。亚组分析显示五组之间无显著差异。