首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: An analysis of survival and treatment toxicities
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Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: An analysis of survival and treatment toxicities

机译:868例鼻咽癌患者调强放疗的远期疗效:生存和治疗毒性分析

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Background and purpose To evaluate the long-term survival outcomes and toxicity of NPC patients treated with intensity-modulated radiotherapy (IMRT). Materials and methods From May 2001 to October 2008, 868 non-metastatic NPC patients treated by IMRT were analyzed retrospectively. The Radiation Therapy Oncology Group (RTOG) criteria were used to assess toxicity. Results With a median follow-up of 50 months (range, 5-115 months), the 5-year estimated disease specific survival (DSS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) were 84.7%, 91.8%, 96.4% and 84.6%, respectively. Of the 868 patients, 186 (21.3%) developed failure after treatment. Distant metastasis was the major failure pattern after treatment. The 5-year OS rate in patients with stage I, II, III, and IVa-b were 100.0%, 94.3%, 83.6%, and 70.5%, respectively. The 5-year LRFS rate in patients with stage T1, T2, T3, and T4 disease were 100.0%, 96.0%, 90.4%, and 83.3%, respectively (χ2 = 26.32, P 0.001). The 5-year DMFS for N0, N1, N2, and N3 patients were 96.1%, 85.6%, 73.7%, and 62.1%, respectively (χ2 = 65.54, P 0.001). Concurrent chemotherapy failed to improve survival rates for patients with advanced locoregional disease. The most common acute toxicities were mainly in grade 1 or 2. Compared with IMRT alone, IMRT plus concurrent chemotherapy increased the severity of acute toxicities. The incidence of brain radiation damage was relatively high (5.5%, 48/868 cases), and was not observed in patients with stage T1-2. Conclusion IMRT for NPC yielded excellent survival outcomes, and distant metastasis was the most commonly seen failure pattern after treatment. The role of concurrent chemotherapy for advanced locoregional stage NPC patients needs to be further investigated. Treatment-related toxicities were well tolerable. However, the incidence of brain radiation damage was relatively high, especially for patients with advanced T-stage.
机译:背景和目的评价经强度调节放疗(IMRT)治疗的NPC患者的长期生存结果和毒性。材料与方法2001年5月至2008年10月,对868例经IMRT治疗的非转移性NPC患者进行回顾性分析。放射治疗肿瘤学小组(RTOG)的标准用于评估毒性。结果平均随访50个月(范围5-115个月),估计5年的疾病特异性存活率(DSS),局部无复发生存率(LRFS),区域无复发生存率(RRFS)和远处无转移生存率(DMFS)分别为84.7%,91.8%,96.4%和84.6%。在868例患者中,有186例(21.3%)在治疗后出现衰竭。远处转移是治疗后的主要失败方式。 I,II,III和IVa-b期患者的5年OS率分别为100.0%,94.3%,83.6%和70.5%。 T1,T2,T3和T4期患者的5年LRFS率分别为100.0%,96.0%,90.4%和83.3%(χ2= 26.32,P <0.001)。 N0,N1,N2和N3患者的5年DMFS分别为96.1%,85.6%,73.7%和62.1%(χ2= 65.54,P <0.001)。并行化疗未能提高晚期局部区域性疾病患者的生存率。最常见的急性毒性主要是1级或2级。与仅IMRT相比,IMRT加同步化疗增加了急性毒性的严重性。脑辐射损伤的发生率相对较高(5.5%,48/868例),在T1-2期患者中未观察到。结论IMRT用于NPC具有良好的生存结局,远处转移是治疗后最常见的失败模式。并发化疗在晚期局部区域NPC患者中的作用有待进一步研究。与治疗相关的毒性耐受性良好。但是,脑辐射损害的发生率相对较高,尤其是对于晚期T期患者。

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