Comparing treatment outcomes of different chemotherapy sequences during intensity modulated radiotherapy for advanced N-stage nasopharyngeal carcinoma patients.
Comparing treatment outcomes of different chemotherapy sequences during intensity modulated radiotherapy for advanced N-stage nasopharyngeal carcinoma patients.
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DOI：
10.1186/1748-717x-8-265
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发表时间：
2013-11-13
期刊：
影响因子：
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通讯作者：
Lu T
中科院分区：
文献类型：
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作者：
Sun X;Zeng L;Chen C;Huang Y;Han F;Xiao W;Liu S;Lu T
鼻咽癌n期与鼻咽癌远处转移有关。我们进行了这项研究，以比较不同的化疗顺序在晚期n期（N2和N3）鼻咽癌患者接受调强放疗（IMRT）治疗的疗效。回顾性分析2001 ~ 2008年198例晚期n期鼻咽癌患者的临床资料。33例患者单独接受IMRT治疗。同步放化疗（CCRT） 72例，新辅助化疗(NACT) + CCRT 82例，CCRT +辅助化疗（AC） 11例。单纯IMRT组和放化疗组的5年总生存率、无复发生存率、无远处转移生存率和无进展生存率分别为47.7%和73.1%（p<0.001）、74.5%和91.3% （p = 0.004）、49.2%和68.5% （p = 0.018）、37.5%和63.8% （p<0.001）。亚组分析显示，CCRT、NACT + CCRT和CCRT + AC组患者的生存曲线差异无统计学意义。生存获益主要来自于CCRT。与单纯RT组相比，CCRT组远端无转移生存率仅有改善的趋势（p = 0.107），而NACT + CCRT能显著提高远端无转移生存率（p = 0.017）。对于晚期n期鼻咽癌患者，NACT + CCRT可能是一种合理的治疗策略。
N-stage is related to distant metastasis of nasopharyngeal carcinoma (NPC) patients. We performed this study to compare the efficacy of different chemotherapy sequences in advanced N-stage (N2 and N3) NPC patients treated with intensity modulated radiotherapy (IMRT). From 2001 to 2008, 198 advanced N-stage NPC patients were retrospectively analyzed. Thirty-three patients received IMRT alone. Concurrent chemoradiotherapy (CCRT) was delivered to 72 patients, neoadjuvant chemotherapy (NACT) + CCRT to 82 patients and CCRT + adjuvant chemotherapy (AC) to 11 patients. The 5-year overall survival rate, recurrence-free survival rate, distant metastasis-free survival rate and progress-free survival rate were 47.7% and 73.1%(p<0.001), 74.5% and 91.3% (p = 0.004), 49.2% and 68.5% (p = 0.018), 37.5% and 63.8% (p<0.001) in IMRT alone and chemoradiotherapy group. Subgroup analyses indicated that there were no significant differences among the survival curves of CCRT, NACT + CCRT and CCRT + AC groups. The survival benefit mainly came from CCRT. However, there was only an improvement attendency in distant metastasis-free survival rate of CCRT group (p = 0.107) when compared with RT alone group, and NACT + CCRT could significantly improve distant metastasis-free survival (p = 0.017). For advanced N-stage NPC patients, NACT + CCRT might be a reasonable treatment strategy.