同期放化疗对比单纯放疗治疗非高发区T1~2N1M0期鼻咽癌远期疗效观察

目的:回顾性配对分析以适形调强放疗为基础的不同治疗模式对非高发区T1~2N1M0期鼻咽癌患者预后的影响。方法:回顾性分析2010年1月至2015年12月河南省肿瘤医院初治的行根治性放疗的T1~2N1M0期鼻咽癌患者,筛选出51对患者(单纯放疗组和同期放化疗组各51例)进行配对分析。比较两组患者各项生存率及急性不良反应。结果:全组5年总生存率、无局部复发生存率、无区域复发生存率、无远处转移生存率分别为94.1%、93.6%、96.7%、90.9%。单纯放疗组与同期放化疗组相比,5年总生存率(95.9%vs. 92.2%,P=0.894)、无局部复发生存率(94.1%vs. 93.3%,P=0.976)、无区域复发生存率(95.8%vs. 97.6%,P=0.572)、无远处转移生存率(91.4%vs. 90.2%,P=0.716),差异均无统计学意义。急性不良反应方面,与单纯放疗组相比,同期放化疗组呕吐、中性粒细胞减少、白细胞减少、血红蛋白减少和黏膜炎的发生率显著升高。结论:对于T1~2N1M0期鼻咽癌患者,同期化疗的加入并未明显改善患者预后,且急性不良反应增加。

Comparison of efficacy of concurrent chemoradiotherapy and intensity-modulated radiotherapy alone for patients with stage T1-2N1M0 nasopharyngeal carcinoma in an unendemic area

  Objective  To compare the efficacy of intensity-modulated radiotherapy (IMRT) alone and concurrent chemoradiotherapy (CCRT) for patients with stage T1-2N1M0 nasopharyngeal carcinoma (NPC) in an unendemic area.  Methods  Between January 2010 and December 2015, 102 patients with stage T1-2N1M0 NPC who underwent radical radiotherapy were selected for a pair analysis. Survival rates and acute adverse reactions were compared between the two groups.  Results  The 5-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were 94.1%, 93.6%, 96.7%, and 90.9%, respectively. Compared with IMRT alone, CCRT failed to significantly improve the 5-year OS (95.9% vs. 92.2%, P=0.894), LRFS (94.1% vs. 93.3%, P=0.976), RRFS (95.8% vs. 97.6%, P=0.572) and DMFS (91.4% vs. 90.2%, P=0.716)rates. The incidence rates of vomiting, neutropenia, leukopenia, decreased hemoglobin levels, and mucositis were significantly higher in the CCRT group than in the IMRT-alone group.  Conclusions  For patients with stage T1-2N0M0 disease, CCRT failed to improve the prognosis, but increased the incidence rates of acute toxicities.