Survival benefit of adding chemotherapy to intensity modulated radiation in patients with locoregionally advanced nasopharyngeal carcinoma.
Survival benefit of adding chemotherapy to intensity modulated radiation in patients with locoregionally advanced nasopharyngeal carcinoma.
复制标题
调强放疗联合化疗对局部晚期鼻咽癌患者的生存获益
DOI：
10.1371/journal.pone.0056208
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zheng Y
中科院分区：
文献类型：
--
作者：
Ji X;Xie C;Hu D;Fan X;Zhou Y;Zheng Y
目的评价局部晚期鼻咽癌调强放疗（IMRT）中化疗的作用，探讨最佳的联合治疗策略。患者与方法2006年至2010年，276例II-IVb期鼻咽癌患者接受了单独IMRT或IMRT加化疗。以顺铂为基础的化疗方案包括新辅助化疗方案或同期化疗方案，或新辅助加同期化疗方案。结果在平均随访33.8个月的情况下，单纯调强放疗组和放化疗组的总生存率（OS）、无转移生存率（MFS）、无复发生存率（RFS）和无病生存率（DFS）分别为90.3%、84.2%、80.3%、80.3%和80.3%。69.2%。与IMRT单独治疗组相比，接受同步放化疗治疗的患者DFS显著更好（HR = 2.64; 95% CI，1.12 - 6.22; P = 0.03），接受新辅助放化疗的患者RFS和DFS显著改善（HR = 4.03; 95% CI，1.35 - 12.05; P = 0.01和HR = 2.43; 95% CI，1.09 - 5.44; P = 0.03），新辅助放化疗在OS、MFS、RFS和DFS方面未提供显著获益。 分期、饮酒是影响OS的预后因素，N分期是影响DFS的重要因素。结论调强放疗加化疗或化疗加化疗可延长局部晚期鼻咽癌的RFS或DFS。这些工作有助于指导有效的个体化治疗。
Background To evaluate the contribution of chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensity modulated radiotherapy (IMRT) and to identify the optimal combination treatment strategy. Patients and Methods Between 2006 and 2010, 276 patients with stage II-IVb NPC were treated by IMRT alone or IMRT plus chemotherapy. Cisplatin-based chemotherapy included neoadjuvant or concurrent, or neoadjuvant plus concurrent protocols. The IMRT alone and chemoradiotherapy groups were well-matched for prognostic factors, except N stage, with more advanced NPC in the chemoradiotherapy arm. Results With a mean follow-up of 33.8 months, the 3-year actuarial rates of overall survival (OS), metastasis-free survival (MFS), relapse-free survival (RFS), and disease-free survival (DFS) were 90.3%, 84.2%, 80.3%, and 69.2% for all of the patients, respectively. Compared with the IMRT alone arm, patients treated by concurrent chemoradiotherapy had a significantly better DFS (HR = 2.64; 95% CI, 1.12−6.22; P = 0.03), patients with neoadjuvant-concurrent chemoradiotherapy had a significant improvement in RFS and DFS (HR = 4.03; 95% CI, 1.35−12.05; P = 0.01 and HR = 2.43; 95% CI, 1.09−5.44; P = 0.03), neoadjuvant chemoradiotherapy provided no significant benefit in OS, MFS, RFS, and DFS. Stage group and alcohol consumption were prognostic factors for OS and N stage was a significant predictor for DFS. Conclusions Addition of concurrent or neoadjuvant-concurrent chemotherapy to IMRT is available to prolong RFS or DFS for locoregionally advanced NPC. Such work could be helpful to guide effective individualized therapy.
登录
查看更多内容
DOI：
10.1016/s0360-3016(00)00447-8
发表时间：
2000-06-01
影响因子：
7
作者：
Fields, MT;Eisbruch, A;Lawrence, TS
通讯作者：
Lawrence, TS
DOI：
10.1016/j.ijrobp.2007.12.054
发表时间：
2008-10-01
影响因子：
7
作者：
Fang, Fu-Min;Chien, Chih-Yen;Huang, Hsuan-Ying
通讯作者：
Huang, Hsuan-Ying
影响因子：
45.3
作者：
Wee, J;Tan, EH;Machin, D
通讯作者：
Machin, D
影响因子：
45.3
作者：
Langendijk, JA;Leemans, CR;Slotman, BJ
通讯作者：
Slotman, BJ
影响因子：
--
作者：
Su SF;Han F;Zhao C;Huang Y;Chen CY;Xiao WW;Li JX;Lu TX
通讯作者：
Lu TX