Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: A 10-year experience with a large cohort and long follow-up
Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: A 10-year experience with a large cohort and long follow-up
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与传统二维放疗相比，调强放疗延长鼻咽癌患者的生存期：大队列、长期随访的10年经验
DOI：
10.1016/j.ejca.2015.08.006
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发表时间：
2015-11-01
影响因子：
8.4
通讯作者：
Chen, Ming-Yuan
中科院分区：
文献类型：
--
作者：
Zhang, Meng-Xia;Li, Jing;Chen, Ming-Yuan
方法：回顾分析2002年2月至2011年12月7081例鼻咽癌根治性调强放疗或2D-CRT患者，其中2245例(31.7%)接受调强放疗，4836例(68.3%)接受2D-CRT治疗。5年后调强放疗患者的局部无复发生存率、局部无复发生存率、无进展生存率和总生存率分别为95.6%、92.5%、82.1%和87.4%，明显高于2D-RT组(分别为90.8%、88.5%、76.7%和84.5%；p<；0.001)。调强放疗的无远处转移生存率(DMF)高于2D-CRT，差异有统计学意义(分别为87.6%和85.7%；P=0.056)。然而，调强放疗和2D-CRT的无复发生存率(NRFS)分别为96.3%和97.4%，差异无统计学意义(P=0.217)。多因素分析显示，IMRT是影响LRFS、LRRFS和PFS的独立预后因素，而不是NRFS、DMFS和OS的保护性预后因素。结论：与2D-CRT相比，IMRT在非播散型鼻咽癌的早期和晚期T分期及总体分期方面均有明显改善。然而，当使用调强放疗时，NRFS、DMFS或OS没有明显的优势。(C)2015爱思唯尔有限公司。保留所有权利。
Background: To evaluate the survival benefit of intensity-modulated radiotherapy (IMRT) compared with conventional two-dimensional radiotherapy (2D-CRT) in nasopharyngeal carcinoma (NPC) using a large cohort with long follow-up.Methods: We retrospectively analysed 7081 non-metastatic NPC patients who received curative IMRT or 2D-CRT from February 2002 to December 2011.Results: Of the 7081 patients, 2245 (31.7%) were administered IMRT, while 4836 (68.3%) were administered 2D-CRT. At 5 years, the patients administered IMRT had significantly higher local relapse-free survival (LRFS), loco-regional relapse-free survival (LRRFS), progression-free survival (PFS) and overall survival (OS) (95.6%, 92.5%, 82.1% and 87.4%, respectively) than those administered 2D-CRT (90.8%, 88.5%, 76.7% and 84.5%, respectively; p < 0.001). The distant metastasis-free survival (DMFS) was higher for IMRT than 2D-CRT, with borderline significance (87.6% and 85.7%, respectively; p = 0.056). However, no difference was observed between IMRT and 2D-CRT in nodal relapse-free survival (NRFS; 96.3% and 97.4%, respectively; p = 0.217). Multivariate analyses showed that IMRT was an independent protective prognostic factor for LRFS, LRRFS and PFS, but not NRFS, DMFS or OS.Conclusions: IMRT provided an improved LRFS, LRRFS and PFS in both the early and advanced T classifications and overall stage for non-disseminated NPC compared with 2D-CRT. However, no significant advantage was observed in NRFS, DMFS or OS when IMRT was used. (C) 2015 Elsevier Ltd. All rights reserved.