Prognostic significance of the total dose of cisplatin administered during concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma
Prognostic significance of the total dose of cisplatin administered during concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma
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DOI：
10.1016/j.radonc.2011.12.022
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发表时间：
2012-09-01
影响因子：
5.7
通讯作者：
Chan, Anthony T. C.
中科院分区：
文献类型：
--
作者：
Loong, Herbert H.;Ma, Brigette B. Y.;Chan, Anthony T. C.
背景与目的：同步放化疗（CRT）在局部进展期鼻咽癌（NPC）治疗中比单纯放疗（RT）更能提高生存期。本研究探讨了CRT期间顺铂总剂量对预后的影响。材料和方法：回顾性分析参与3项前瞻性研究的II至IVB期NPC （AJCC第6版）患者。所有患者在6-7周的CRT疗程中接受固定剂量40 mg/m(2)/周的顺铂治疗。单因素分析采用卡方检验。使用Cox风险模型分析预后因素、顺铂总剂量和事件终点时间之间的关系。结果：241例患者的分期分布如下：II期= 13.7%，III期= 45.2%，IV期= 41.1%。每位患者给予顺铂的中位总周期数为5个周期（范围1-8个周期）。中位随访56.5个月（4.2-200.2个月），93例患者（38.6%）复发，85例患者（35.2%）死亡。对于所有患者，单因素分析中，顺铂总周期数与生存率显著相关，但多因素分析中没有。在142例II期和III期鼻咽癌患者的亚组分析中，接受顺铂治疗超过5个周期的患者的总生存率明显优于未接受顺铂治疗的患者（风险比0.44；95%可信区间0.23-0.85;p = 0.02）。结论：顺铂周期数是II-III期鼻咽癌患者接受每周一次顺铂CRT治疗的独立预后因素。2012爱思唯尔爱尔兰有限公司版权所有。放射治疗与肿瘤学104 (2012):300-304
Background and purpose: Concurrent chemoradiotherapy (CRT) confers survival benefit over radiotherapy (RT) alone in the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC). This study explored the prognostic significance of the total dose of cisplatin delivered during CRT.Materials and methods: A retrospective analysis was performed in patients with stage II to IVB NPC (AJCC 6th edition) who participated in 3 prospective studies. All patients received cisplatin at a fixed dose of 40 mg/m(2)/week during a 6-7-weeks course of CRT. Chi-square test was used in the univariate analysis. Relationship between prognostic factors, the total dose of cisplatin administered and time-to-event end-points were analyzed with the Cox Hazards model.Results: Two hundred and forty-one patients were identified with the following stage distribution: Stage II = 13.7%, III = 45.2%, IV = 41.1%. The median total number of cycles of cisplatin administered per patient was 5 cycles (range 1-8 cycles). At a median follow-up of 56.5 months (range 4.2-200.2 months), 93 patients (38.6%) had relapsed and 85 patients (35.2%) died. For all patients, the total number of cycles of cisplatin delivered was significantly associated with survival in the univariate but not the multivariate analysis. In a sub-group analysis of 142 patients with stage II and III NPC, patients who received more than 5 cycles of cisplatin had significantly better overall survival than those who did not (hazard ratio 0.44; 95% confidence interval, 0.23-0.85; p = 0.02).Conclusion: Number of cycles of cisplatin delivered is an independent prognostic factor in patients with stage II-III NPC undergoing CRT with weekly cisplatin. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 104 (2012) 300-304