Salvage Intensity-Modulated Radiation Therapy (IMRT) for Locally Recurrent Nasopharyngeal Cancer after Definitive IMRT: A Novel Scenario of the Modern Era.
Salvage Intensity-Modulated Radiation Therapy (IMRT) for Locally Recurrent Nasopharyngeal Cancer after Definitive IMRT: A Novel Scenario of the Modern Era.
复制标题
DOI：
10.1038/srep32883
复制
发表时间：
2016-09-12
影响因子：
4.6
通讯作者：
Lu JJ
中科院分区：
文献类型：
--
作者：
Kong L;Wang L;Shen C;Hu C;Wang L;Lu JJ
确定的调强放疗后局部复发的鼻咽癌(RNPC)发生在所有病例中的10%，是一种独特的临床实体，已经被放射抵抗癌细胞选择性地浓缩。因此，我们报告了77名患者的结果，这些患者在仅进行了确定的调强放疗疗程后，再次接受了rNPC的挽救-调强放疗。测量了不同的临床结果。使用对数等级检验来检测因素定义的亚组之间的生存结果的差异。采用COX比例风险模型进行多变量分析。从复发时间算起，中位随访时间为25.7个月(3.0-75.7个月)。整个队列的中位OS时间和PFS时间分别为37.0个月和20.5个月。死亡34例(44.2%)。这些患者中约有35%死于疾病进展，但53%死于治疗引发的严重不良反应(SAE)，没有疾病进展的证据。多因素分析发现，复发肿瘤的高T分类和SAEs的发生是唯一独立和显著的不良预后因素。这些结果强调了确定的调强放疗后rNPC的特别毒力特征。令人担忧的是再照射毒性对患者死亡率的影响。
Locally recurrent nasopharyngeal carcinoma (rNPC) after definitive IMRT occurs in 10% of all cases and represents a distinct clinical entity that has been selectively enriched by radio-resistant cancer cells. Therefore, we report of the outcomes of 77 patients who had repeat salvage-IMRT for rNPC after only a definitive course of IMRT. Various clinical outcomes were measured. Log-rank tests were used to detect differences in the survival outcomes between factor-defined subgroups. Multivariable analysis was performed using the Cox proportional hazard model. The median follow-up time was 25.7 months (range 3.0–75.7 months), measured from the time of recurrence. The median OS time and PFS time of the entire cohort was 37.0 and 20.5 months, respectively. Thirty-four patients (44.2%) died. Approximately 35% of these patients died from disease progression, but 53% were from treatment-induced severe adverse effects (SAEs) without evidence of disease progression. Higher T-classification of the recurrent tumor and the development of SAEs were found to be the only independent and significant adverse prognostic factors on multivariable analysis. These outcomes underscore the particularly virulent characteristics of rNPC after definitive IMRT. Concerning is the impact of re-irradiation toxicity on patient mortality.
登录
查看更多内容
影响因子：
3.5
作者：
Nieder, C;Milas, L;Ang, KK
通讯作者：
Ang, KK
影响因子：
3.7
作者：
Xiao W;Liu S;Tian Y;Guan Y;Huang S;Lin C;Zhao C;Lu T;Han F
通讯作者：
Han F
DOI：
10.1007/s00405-010-1385-x
发表时间：
2010-12
期刊：
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
影响因子：
--
作者：
Suárez C;Rodrigo JP;Rinaldo A;Langendijk JA;Shaha AR;Ferlito A
通讯作者：
Ferlito A
影响因子：
5.7
作者：
Jensen, Alexandra D.;Poulakis, Melanie;Debus, Juergen
通讯作者：
Debus, Juergen
影响因子：
2.2
作者：
Wang, Y.;Zhang, G. -H.;Li, S. -L.
通讯作者：
Li, S. -L.