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化疗对I期鼻咽癌患者生存的疗效

Efficacy of Chemotherapy in Survival of Stage I Nasopharyngeal Carcinoma.

作者信息

Ma Jia-Lin, Huang Shi-Ting, Jiang Yan-Ming, Pan Xin-Bin

机构信息

Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.

出版信息

Front Oncol. 2021 Oct 14;11:735817. doi: 10.3389/fonc.2021.735817. eCollection 2021.

DOI:10.3389/fonc.2021.735817
PMID:34722284
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8551620/
Abstract

PURPOSE

To identify whether chemoradiotherapy improves survival of stage I nasopharyngeal carcinoma (NPC).

MATERIALS AND METHODS

NPC patients were extracted from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. Pathologically confirmed stage T1N0M0 (the 7 edition AJCC) were investigated. Overall survival (OS) and cancer-specific survival (CSS) were compared between the radiotherapy and chemoradiotherapy groups using the Kaplan-Meier method and propensity score matching (PSM) analyses.

RESULTS

This study included 91 (40.27%) patients in the chemoradiotherapy group and 135 (59.73%) patients in the radiotherapy group. Before PSM, chemoradiotherapy was associated with worse 3-year OS (74.31 87.23%; = 0.025) and 5-year OS (64.28 83.12%; = 0.001) compared to those associated with radiotherapy. Similarly, chemoradiotherapy showed worse 3-year CSS (87.01 96.97%; = 0.028) and 5-year CSS (80.39 96.97%; = 0.002) than those of radiotherapy. After PSM, chemoradiotherapy revealed worse 5-year OS (63.10 82.49%; = 0.031) and CSS (80.95 93.70%; = 0.016) than radiotherapy. The multivariate regression analysis revealed that chemoradiotherapy was an independent risk prognostic factor for OS and CSS before and after PSM.

CONCLUSION

Radiotherapy alone is recommended for stage I NPC patients.

摘要

目的

确定放化疗是否能提高Ⅰ期鼻咽癌（NPC）患者的生存率。

材料与方法

从2010年至2015年的监测、流行病学和最终结果数据库中提取NPC患者。对病理确诊为T1N0M0期（美国癌症联合委员会第7版）的患者进行研究。采用Kaplan-Meier法和倾向评分匹配（PSM）分析比较放疗组和放化疗组的总生存期（OS）和癌症特异性生存期（CSS）。

结果

本研究中放化疗组有91例（40.27%）患者，放疗组有135例（59.73%）患者。在PSM之前，与放疗相比，放化疗与较差的3年OS（74.31%对87.23%；P = 0.025）和5年OS（64.28%对83.12%；P = 0.001）相关。同样，放化疗的3年CSS（87.01%对96.97%；P = 0.028）和5年CSS（80.39%对96.97%；P = 0.002）也比放疗组差。PSM之后，放化疗的5年OS（63.10%对82.49%；P = 0.031）和CSS（80.95%对93.70%；P = 0.016）比放疗组差。多因素回归分析显示，放化疗是PSM前后OS和CSS的独立风险预后因素。

结论

推荐Ⅰ期NPC患者单纯放疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/164093ca6be0/fonc-11-735817-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/89cf858d70b8/fonc-11-735817-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/a47e1dc37a9f/fonc-11-735817-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/c31e112a95c0/fonc-11-735817-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/f55c1ec66c72/fonc-11-735817-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/213530d7d774/fonc-11-735817-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/164093ca6be0/fonc-11-735817-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/89cf858d70b8/fonc-11-735817-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/a47e1dc37a9f/fonc-11-735817-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/c31e112a95c0/fonc-11-735817-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/f55c1ec66c72/fonc-11-735817-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/213530d7d774/fonc-11-735817-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5786/8551620/164093ca6be0/fonc-11-735817-g006.jpg

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Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3333-3344. doi: 10.1007/s00405-020-06593-5. Epub 2021 Jan 31.
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Ten-year outcomes of survival and toxicity for a phase III randomised trial of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma.同期放化疗对比单纯放疗治疗 II 期鼻咽癌的 III 期随机临床试验的 10 年生存和毒性结局。
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