摘要
Abstract
Objective:To analyze the clinical outcomes and prognostic factors of intensity-modulated radiotherapy (IMRT)combined with chemotherapy for T4 stage nasopharyngeal carcinoma (NPC).Methods:From March 2005 to March 2010,110 patients with T4 stage NPC without distant metastases were enrolled in this study.All patients received radical IMRT,combined with induction and /or concurrent chemotherapy.Forty-seven patients(42.7%)received IMRT re-planning.Results:With a median follow-up of 58 months(range,12 ~120 months),for all the patients,the 5-year local recurrence-free survival(LRFS),regional recurrence-free survival(RRFS),distant metastasis-free survival(DMFS),pro-gression-free survival(PFS),and overall survival(OS)were 90.1%,97.0%,67.5%,63.9% and 64.5%,respectively. Eleven patients experienced local regional failure and distant metastasis occurred 34 patients.Among 45 died patients,26 patients died of distant metastasis.The 5-year LRFS was 97.7% for patients treated with IMRT replanning compared with 83.8% for patients who didn’t accept IMRT replanning (P =0.023).Metastasis to retropharyngeal lymph node was associ-ated with inferior 5-year OS (61.0% VS.91.7%,P =0.034 ).GTVln volume was an independent negative prognostic factor for DMFS (P =0.006 )and PFS (P =0.018).Conclusion:IMRT combined with chemotherapy provides excellent local-regional control for T4 stage NPC. Benefit of IMRT replanning may be associated with improve-ment in local control.However,distant metastasis is the major cause of treatment failure.Treatment modalities to reduce the rate of distant metastasis and increase the survival rate of T4 stage NPC effectively should be explored.关键词
鼻咽癌/适形调强放疗/再程调强放疗/疗效/预后因素Key words
Nasopharyngeal Carcinoma/Intensity-modulated Radiotherapy/IMRT Replanning/Clinical Out-come/Prognostic Factor分类
医药卫生
