Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis.
Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis.
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鼻咽癌初诊远处转移患者的局部放疗
DOI：
10.5732/cjc.013.10148
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发表时间：
2013-11
影响因子：
--
通讯作者：
Qian CN
中科院分区：
文献类型：
--
作者：
Chen MY;Jiang R;Guo L;Zou X;Liu Q;Sun R;Qiu F;Xia ZJ;Huang HQ;Zhang L;Hong MH;Mai HQ;Qian CN
全身化疗是转移性鼻咽癌（NPC）的基本姑息治疗方法，但以原发灶和局部淋巴结为靶点的局部放疗是否影响转移性NPC患者的生存率尚不清楚。因此，我们的目的是回顾性评价局部放疗的好处。共408例转移性NPC患者纳入本研究。将接受支持治疗和接受化疗的患者的死亡风险与接受局部区域放疗单独或联合化疗的患者的死亡风险进行比较。进行单变量和多变量分析。在校正与预后显著相关的协变量后，评估独立因素的贡献（P < 0.05）。局部放疗和全身化疗均为影响总生存率的独立预后因素。单纯局部放疗组与单纯全身化疗组的死亡风险相似[多重调整风险比（HR）= 0.9，P = 0.529];这一风险比接受支持治疗的组低60%，与全身化疗加局部放疗组比较，差异有统计学意义（HR = 0.4，P = 0.004），差异有统计学意义（HR = 2.3，P < 0.001）。总之，局部放疗，特别是当与全身化疗相结合时，与转移性NPC患者生存率的提高有关。
Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma (NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P < 0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival (OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio (HR) = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment (HR = 0.4, P = 0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy (HR = 2.3, P < 0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.
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影响因子：
168.9
作者：
Mickisch, GHJ;Garin, A;Sylvester, R
通讯作者：
Sylvester, R
影响因子：
45.3
作者：
Le Scodan, Romuald;Stevens, Denise;Labib, Alain
通讯作者：
Labib, Alain
影响因子：
45.3
作者：
Fandi, A;Bachouchi, M;Cvitkovic, E
通讯作者：
Cvitkovic, E
影响因子：
11.5
作者：
Wang, Wen-Yi;Twu, Chih-Wen;Lin, Jin-Ching
通讯作者：
Lin, Jin-Ching
影响因子：
3.4
作者：
Pan, Changchuan;He, Ni;Wu, Peihong
通讯作者：
Wu, Peihong