Long-term efficacy and adverse reactions of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma in non-endemic northwest China

中华放射肿瘤学杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2020.02.001

Man Xu, M. Shi, J. Zang, Jan-hong Wang, Lina Zhao, S. Luo, F. Xiao

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Abstract

Objective To retrospectively analyze the characteristics of nasopharyngeal carcinoma, long-term efficacy, adverse reactions of intensity-modulated radiotherapy (IMRT) in non-endemic northwest China and summarize the experience of IMRT in the treatment of nasopharyngeal carcinoma in the past decade. Methods Clinical data of 658 patients newly diagnosed with nasopharyngeal carcinoma without distant metastasis admitted to First affiliated hospital from January 2006 to December 2016 were retrospectively analyzed. All patients were treated with IMRT. The survival analysis was performed by Kaplan-Meier method. The multivariate analysis was conducted with Cox’s regression model. Results In non-endemic northwest China, a large proportion of patients were newly diagnosed with locally advanced nasopharyngeal carcinoma, and a majority of them were pathologically characterized as differentiated subtypes. The 5-year overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS) and distant metastasis-free survival (DMFS) rates were 75.7%, 70.1%, 91.2%, 97.0% and 81.0%, respectively. Multivariate analysis showed that age, pathological type, nasopharyngeal tumor volume>23 cm3 and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DFS (all P<0.05). Age, pathological type, neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of OS (all P<0.05). N stage and neck lymph node metastasis complicated with necrosis were the factors of poor prognosis of DMFS (both P<0.05). Conclusions Similar clinical efficacy has been achieved in terms of IMRT for nasopharyngeal carcinoma in non-endemic northwest China compared with that in endemic area. Induction chemotherapy combined with concurrent radiochemotherapy can provide clinical benefits for patients with locally advanced nasopharyngeal carcinoma in non-endemic area. Key words: Nasopharyngeal neoplasm/intensity-modulated radiotherapy; Non-endemic area; Prognosis

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西北非地方性鼻咽癌调强放疗的远期疗效及不良反应分析

目的回顾性分析西北地区非地方性鼻咽癌调强放疗(IMRT)的特点、远期疗效及不良反应，总结近十年来调强放疗治疗鼻咽癌的经验。方法回顾性分析2006年1月至2016年12月第一附属医院收治的658例初诊鼻咽癌无远处转移患者的临床资料。所有患者均接受IMRT治疗。生存率分析采用Kaplan-Meier法。采用Cox回归模型进行多因素分析。结果在西北地区，局部进展期鼻咽癌的新诊断患者占很大比例，多数患者病理表现为分化亚型。5年总生存率(OS)、无病生存率(DFS)、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75.7%、70.1%、91.2%、97.0%和81.0%。多因素分析显示，年龄、病理类型、鼻咽肿瘤体积bbb23 cm3、颈部淋巴结转移合并坏死是影响DFS预后的因素(均P<0.05)。年龄、病理类型、颈部淋巴结转移合并坏死是影响OS预后的因素(均P<0.05)。N分期及颈部淋巴结转移合并坏死是DMFS预后不良的因素(P<0.05)。结论西北地区鼻咽癌非流行区与流行区相比，IMRT治疗鼻咽癌的临床疗效相近。诱导化疗联合放化疗可为非流行区局部晚期鼻咽癌患者提供临床获益。关键词:鼻咽肿瘤/调强放疗;非区域;预后

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中华放射肿瘤学杂志

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6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.