Objective To retrospectively analyze the efficacy and toxicity of intensity⁃modulated radiotherapy ( IMRT) alone and IMRT with concurrent chemotherapy ( CRT) in the treatment of early⁃stage nasopharyngeal carcinoma ( NPC) using pairwise group comparison. Methods A total of 98 patients with stage T1⁃2N1M0 NPC were treated with IMRT alone or CRT from 2009 to 2010, and 39 pairs out of them were selected for comparison of efficacy and toxicity. The survival rates were calculated using the Kaplan⁃Meier method and analyzed using the log⁃rank test. Results The 3⁃year follow⁃up rate was 95%. There were no significant differences in the 3⁃year overall survival ( OS ) , progression⁃free survival ( PFS ) , local recurrence⁃free survival ( LRFS ) , and distant metastasis⁃free survival ( DMFS ) rates between the IMRT alone group and the CRT group ( 97% vs. 95%, P=0�411;97% vs. 92%, P=0�301;97% vs. 97%, P=0�606;100% vs. 92%, P=0�082) . The incidence rates of leucopenia, anemia, and thrombocytopenia were significantly higher in the CRT group than in the IMRT alone group ( P=0�000;P=0�000;P=0�000 ) . There were no significant differences in the incidence rates of grade 3 oral mucositis and hearing loss between the IMRT alone group and the CRT group ( 26% vs. 23%, P= 0�093;41% vs. 62%, P= 0�100 ) . Conclusions CRT fails to increase the OS, PFS, and LRFS rates and reduce the DMFS rate in patients with stage T1⁃2 N1 NPC. Moreover, CRT results in higher incidence rates of hematotoxicity, grade 3 mucositis, and hearing loss than IMRT alone.%目的：回顾性成组配对分析早期鼻咽癌单纯IMRT与IMRT同期化疗疗效及不良反应。方法2009—2010年共98例T1⁃2 N1 M0期鼻咽癌患者行单纯放疗或同期放化疗，筛选出39对患者进行疗效及不良反应对比分析。 Kaplan⁃Meier法计算生存率且Logrank法检验。结果3年随访率为95％。单纯IMRT组和同期放化疗组3年OS率分别为97％、95％（ P＝0�411），PFS率分别为97％、92％（ P＝0�301），LRFS率分别为97％、97％（ P＝0�606），DMFS率分别为100％、92％（ P＝0�082）。白细胞减少、贫血、血小板减少发生率同期放化疗组大于单纯IMRT组（P＝0�000、0�000、0�000），单纯IMRT组与同期放化疗组3级口腔口咽黏膜炎发生率分别为26％和36％（ P＝0�093），听力下降发生率分别为41％、62％（ P＝0�100）。结论同期化疗联合IMRT未能提高早期鼻咽癌T1⁃2 N1期患者OS、PFS、LRFS率，亦未能降低DMFS率；且血液毒性、3级黏膜炎、听力下降发生率较单纯IMRT组高。
展开▼
