Nasopharyngeal carcinomas:: analysis of patient, tumor and treatment characteristics determining outcome
Nasopharyngeal carcinomas:: analysis of patient, tumor and treatment characteristics determining outcome
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DOI：
10.1016/s0167-8140(01)00448-0
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发表时间：
2001-12-01
影响因子：
5.7
通讯作者：
Çakmak, A
中科院分区：
文献类型：
--
作者：
Erkal, HS;Serin, M;Çakmak, A
目的：回顾447例鼻咽癌患者的治疗经验，分析患者、肿瘤及治疗特点，确定预后。材料与方法：男性322例，女性125例，年龄7 ~ 85岁，中位45岁。272例患者为世界卫生组织（WHO） 3型癌，123例患者为T4肿瘤，320例患者为转移性颈部淋巴结。308例患者单独接受放射治疗，139例患者接受化疗联合放射治疗。原发肿瘤的累积辐射剂量为50 ~ 76 Gy（中位为70 Gy），转移性颈部淋巴结的辐射剂量为50 ~ 76 Gy。从46到74戈瑞（中位数66戈瑞）。结果：随访0.1 ~ 19.5年（平均7.6年）。357例患者局部完全缓解。在多变量分析中，t分类、原发肿瘤累积辐射剂量和化疗联合放疗预测局部反应。272例患者达到淋巴结完全缓解。在多变量分析中，n分类和转移性颈部淋巴结的放射剂量预测淋巴结反应。局部衰竭70例，淋巴结衰竭35例，全身衰竭114例。10年的总生存率、无病生存率和疾病特异性生存率分别为33.32%和37%。在多变量分析中，年龄、t分类、n分类、放疗剂量和化疗与放疗联合治疗预测总生存期，而t分类预测总生存期。n分类、放射剂量和化疗联合放射治疗预测无病生存期和疾病特异性生存期。结论：对于早期鼻咽癌患者，单独放疗似乎是一种适当且可行的治疗方法，而化疗联合放疗似乎可以改善晚期鼻咽癌患者的预后。(C) 2001爱思唯尔科学爱尔兰有限公司版权所有。
Purpose: The present study reviews the experience in treatment of 447 patients with nasopharyngeal carcinomas, analyzing patient, tumor and treatment characteristics determining outcome.Materials and methods: There were 322 males and 125 females, their ages ranging from 7 to 85 years (median, 45 years). Two-hundred and seventy-two patients had World Health Organization (WHO) type 3 carcinomas, 123 patients had T4 tumors and 320 patients had metastatic cervical lymph nodes. Three-hundred and eight patients were treated with radiation therapy alone and 139 patients with chemotherapy in combination with radiation therapy. Cumulative radiation dose to primary tumor ranged from 50 to 76 Gy (median, 70 Gy) and radiation dose to metastatic cervical lymph nodes ranged. from 46 to 74 Gy (median, 66 Gy).Results: Follow-up ranged from 0.1 to 19.5 years (mean, 7.6 years). Local complete response was achieved in 357 patients. In multivariate analysis, T-classification, cumulative radiation dose to primary tumor and treatment with chemotherapy in combination with radiation therapy predicted local response. Nodal complete response was achieved in 272 patients. In multivariate analysis, N-classification and radiation dose to metastatic cervical lymph nodes predicted nodal response. Local failure was observed in 70 patients, nodal failure in 35 patients and systemic failure in 114 patients. Overall survival, disease-free survival and disease-specific survival were 33, 32 and 37%, respectively, at 10 years. In multivariate analysis, age, T-classification, N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted overall survival whereas T-classification. N-classification, radiation dose and treatment with chemotherapy in combination with radiation therapy predicted both disease-free survival and disease-specific survival.Conclusions: Radiation therapy alone appears to be an adequate and viable treatment for patients with early-stage nasopharyngeal carcinomas, whereas treatment with chemotherapy in combination with radiation therapy appears to improve outcome for patients with advanced-stage nasopharyngeal carcinomas. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.