适形调强放射治疗时代同期化疗对中危鼻咽癌的治疗价值探讨
发布时间：2019-05-19 19:52
【摘要】：【目的】探讨在适形调强放射治疗(IMRT)时代同期化疗对中危鼻咽癌(II期及T3N0M0期)的治疗价值。【方法】将2009年10月至2012年12月中山大学附属肿瘤防治中心共440例单纯IMRT治疗或IMRT治疗及同期化疗的中危鼻咽癌患者纳入研究。使用倾向性评分匹配的方法,得到宿主以及肿瘤因素均衡匹配的单纯放疗组和同期放化疗组。【结果】全组患者中位随访时间为37.3个月。在匹配前,接受单纯IMRT治疗的患者对比接受IMRT治疗及同期化疗的患者,估计三年无瘤生存(FFS)、局部区域无复发生存(LR-FFS)、无远处转移生存(D-FFS)、总生存(OS)差异无统计学意义。在多因素分析中,同期化疗并非3年FFS、LR-FFS、D-FFS、OS的独立预后因素。然而,在接受IMRT治疗及同期化疗的患者发生严重急性毒性较接受单纯IMRT治疗的患者显著增多;在匹配后,单纯放疗组和同期放化疗组在各项生存终点均无显著差异(FFS:92.8%vs 91.2%,P=0.801;LR-FFS:95.2%vs 94.4%,P=0.755;D-FFS:96.4%vs 96.3%,P=0.803;OS:98.2%vs 98.9%,P=0.276)。【结论】对于IMRT治疗下的中危鼻咽癌患者,同期化疗并不能带来生存获益,却显著增加了急性严重毒性的发生,同期化疗是否应作为中危鼻咽癌患者的常规治疗值得进一步的探讨。
[Abstract]:[objective] to evaluate the value of concurrent chemotherapy in the treatment of moderately dangerous nasopharyngeal carcinoma (II stage and T3N0M0 stage) in the era of conformal intensity modulation radiotherapy (IMRT). [methods] from October 2009 to December 2012, the Cancer Prevention and treatment Center affiliated to Sun Yat-sen University was used. Four hundred and forty patients with moderate and critical nasopharyngeal carcinoma treated with IMRT or IMRT alone and chemotherapy at the same time were included in the study. The host and tumor factor balanced matching radiotherapy group and simultaneous radiotherapy and chemotherapy group were obtained by tendency score matching. [results] the median follow-up time was 37.3 months. Before matching, patients treated with IMRT alone compared with patients treated with IMRT and chemotherapy at the same time, it was estimated that there was no recurrence survival (LR-FFS) and no distant metastasis survival (D-FFS) in the local area of (FFS), without tumor survival for three years. There was no significant difference in total survival (OS). In multivariate analysis, simultaneous chemotherapy was not an independent prognostic factor for 3 years of FFS,LR-FFS,D-FFS,OS. However, the incidence of severe acute toxicity in patients treated with IMRT and chemotherapy at the same time was significantly higher than that in patients treated with IMRT alone. After matching, there was no significant difference between radiotherapy alone group and radiotherapy and chemotherapy group at each survival end point (FFS:92.8%vs 91.2%, P 鈮，
本文编号：2481025
[Abstract]:[objective] to evaluate the value of concurrent chemotherapy in the treatment of moderately dangerous nasopharyngeal carcinoma (II stage and T3N0M0 stage) in the era of conformal intensity modulation radiotherapy (IMRT). [methods] from October 2009 to December 2012, the Cancer Prevention and treatment Center affiliated to Sun Yat-sen University was used. Four hundred and forty patients with moderate and critical nasopharyngeal carcinoma treated with IMRT or IMRT alone and chemotherapy at the same time were included in the study. The host and tumor factor balanced matching radiotherapy group and simultaneous radiotherapy and chemotherapy group were obtained by tendency score matching. [results] the median follow-up time was 37.3 months. Before matching, patients treated with IMRT alone compared with patients treated with IMRT and chemotherapy at the same time, it was estimated that there was no recurrence survival (LR-FFS) and no distant metastasis survival (D-FFS) in the local area of (FFS), without tumor survival for three years. There was no significant difference in total survival (OS). In multivariate analysis, simultaneous chemotherapy was not an independent prognostic factor for 3 years of FFS,LR-FFS,D-FFS,OS. However, the incidence of severe acute toxicity in patients treated with IMRT and chemotherapy at the same time was significantly higher than that in patients treated with IMRT alone. After matching, there was no significant difference between radiotherapy alone group and radiotherapy and chemotherapy group at each survival end point (FFS:92.8%vs 91.2%, P 鈮，
本文编号：2481025
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