Prognostic factors and survival in patients with radiation-related second malignant neoplasms following radiotherapy for nasopharyngeal carcinoma.
Prognostic factors and survival in patients with radiation-related second malignant neoplasms following radiotherapy for nasopharyngeal carcinoma.
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鼻咽癌放疗后与放射相关的第二恶性肿瘤患者的预后因素和生存率。
DOI：
10.1371/journal.pone.0084586
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Liu MZ
中科院分区：
文献类型：
--
作者：
Xi M;Liu SL;Zhao L;Shen JX;Zhang L;Zhang P;Liu MZ
分析大量鼻咽癌（NPC）放射相关继发恶性肿瘤（SMNs）的临床病理特征、治疗方式和潜在预后因素。审查了1964年2月至2003年12月期间接受确定性放疗的39，118名NPC患者的机构电子病历。共纳入247例确诊为放疗所致SMN的患者。鼻咽癌放疗与SMN诊断之间的中位潜伏期为9.5年（范围，3.1-36.8年）。组织学类型以鳞状细胞癌最常见，其次为纤维肉瘤和腺癌。接受治疗的235例患者的中位无进展生存期和总生存期（OS）分别为17.3个月和28.5个月。手术、放疗和化疗组的5年OS率分别为42.9%、23.7%和0%。与生存相关的独立预后因素是性别、组织学类型和治疗方式，在早期亚组和晚期亚组中均是如此。性别、组织学类型和治疗方式是SMN的重要预后因素。完全切除为长期生存提供了最好的机会。在选择的局部晚期和不可切除的SMN患者中，应强烈考虑将再照射作为一种治疗选择。
To analyze the clinicopathological characteristics, treatment modalities, and potential prognostic factors of radiation-related second malignant neoplasms (SMNs) in a large group of nasopharyngeal carcinoma (NPC) cases. Institutional electronic medical records of 39,118 patients with NPC treated by definitive radiotherapy between February 1964 and December 2003 were reviewed. A total of 247 patients with confirmed SMN attributable to radiotherapy were included. Median latency between radiotherapy for NPC and the diagnosis of SMN was 9.5 years (range, 3.1–36.8 years). Squamous cell carcinoma was the most common histologic type, followed by fibrosarcoma and adenocarcinoma. Median progression-free survival and overall survival (OS) of the 235 patients who underwent treatment were 17.3 months and 28.5 months, respectively. The 5-year OS rates were 42.9%, 23.7%, and 0% for the surgery, radiotherapy, and chemotherapy groups, respectively. The independent prognostic factors associated with survival were sex, histologic type, and treatment modality in both the early stage subgroup and the advanced stage subgroup of SMN. Sex, histologic type, and treatment modality were the significant prognostic factors for SMN. Complete resection offers the best chance for long-term survival. In select patients with locally advanced and unresectable SMN, reirradiation should be strongly considered as a curative option.
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影响因子：
9
作者：
Cha, C;Antonescu, CR;Brennan, MF
通讯作者：
Brennan, MF
DOI：
10.1016/j.ijrobp.2010.02.023
发表时间：
2011-07-01
影响因子：
7
作者：
Chen, Allen M.;Farwell, D. Gregory;Purdy, James A.
通讯作者：
Purdy, James A.
DOI：
10.1016/s0360-3016(02)04613-8
发表时间：
2003-06-01
影响因子：
7
作者：
Gao, X;Fisher, SG;Emami, B
通讯作者：
Emami, B
影响因子：
2.6
作者：
Liu, WW;Wu, QL;Zeng, ZY
通讯作者：
Zeng, ZY
影响因子：
51.1
作者：
de Gonzalez, Amy Berrington;Curtis, Rochelle E.;Kry, Stephen F.;Gilbert, Ethel;Lamart, Stephanie;Berg, Christine D.;Stovall, Marilyn;Ron, Elaine
通讯作者：
Ron, Elaine