Reirradiation for locally recurrent nasopharyngeal carcinoma:: Treatment results and prognostic factors
Reirradiation for locally recurrent nasopharyngeal carcinoma:: Treatment results and prognostic factors
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DOI：
10.1016/j.ijrobp.2004.03.021
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发表时间：
2004-10-01
影响因子：
7
通讯作者：
Turkan, S
中科院分区：
文献类型：
--
作者：
Öksüz, DÇ;Meral, G;Turkan, S
目的：分析鼻咽癌局部复发再治疗的疗效及影响预后的因素。方法与材料：对1979~2000年间41例鼻咽癌局部复发再放疗患者的临床资料进行回顾性分析。男32例，女9例，中位年龄46岁。组织学类型：WHO I期9例(22%)，WHO II期17例(41.5%)，WHO III期15例(36.5%)。根据美国癌症联合委员会1998年TNM分期标准，复发病例I期5例(12.2%)，II期2例(26.8%)，III期6例(14.6%)，IV期19例(46.4%)。治疗采用4~6 MV X线或Co-60伽玛线。中位再照射剂量为50Gy.治疗剂量为1.8~2Gy/次，每周5天，每日1次。结果：中位随访时间23个月(3~143个月)。2年和5年局部无进展生存率和总生存率分别为39%、23%、48%和28%。单因素分析显示，年龄(p=0.04)、总再照射剂量(p=0.0008)是影响局部无进展率的显著预后因素。总再照射剂量、分期、T分期对总生存年龄有显著影响。在多因素分析中，仅总剂量(p=0.005)对局部无进展率有显著影响，总再照射剂量(p=0.02)、复发间隔(p=0.03)、分期(p=0.018)对总生存率有显著影响。结论：早期诊断局部复发和大剂量再照射(60Gy)对提高局部控制和生存率至关重要。(C)2004年爱思唯尔公司。
Purpose: To analyze the results and evaluate the prognostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma.Methods and Materials: Forty-one patients with locally recurrent nasopharyngeal carcinoma, who were reirradiated between 1979 and 2000, were retrospectively analyzed. There were 32 men and 9 women with median age of 46 years. Histologically, 9 tumors (22%) were World Health Organization (WHO) I, 17 (41.5%) WHO II, and 15 (36.5%) WHO III. According to the 1998 TNM staging system of the American Joint Committee on Cancer, the recurrent disease was Stage I in 5 (12.2%), Stage II in It (26.8%), Stage III in 6 (14.6%), and Stage IV in 19 (46.4%) patients. Treatment was delivered with 4-6 MV X-rays or Co-60 gamma rays. The median reirradiation dose was 50 Gy. Treatment was delivered at 1.8-2 Gy/fraction daily, 5 days a week. Chemotherapy was used in 41.5% of the patients.Results: Median follow-up was 23 months (range, 3-143 months). The 2-year and 5-year local progression-free and overall survival rates were 39%, 23%, 48%, and 28%, respectively. On univariate analysis, age (p = 0.04), total reirradiation dose (p = 0.0008) were significant prognostic factors for local progression-free rate. For overall survival age, total reirradiation dose, stage, T stage were significant. On multivariate analysis only total dose (p = 0.005) remained significant for local progression-free rate and total reirradiation dose (p = 0.02), interval to recurrence (p = 0.03), stage (p = 0.018) were significant for overall survival.Conclusions: Early diagnosis of local recurrence and high-dose reirradiation (60 Gy) are crucial for improving the local control and survival. (C) 2004 Elsevier Inc.