【摘要】：【目的】探討在適形調(diào)強放射治療(IMRT)時代同期化療對中危鼻咽癌(II期及T3N0M0期)的治療價值。【方法】將2009年10月至2012年12月中山大學附屬腫瘤防治中心共440例單純IMRT治療或IMRT治療及同期化療的中危鼻咽癌患者納入研究。使用傾向性評分匹配的方法,得到宿主以及腫瘤因素均衡匹配的單純放療組和同期放化療組�！窘Y果】全組患者中位隨訪時間為37.3個月。在匹配前,接受單純IMRT治療的患者對比接受IMRT治療及同期化療的患者,估計三年無瘤生存(FFS)、局部區(qū)域無復發(fā)生存(LR-FFS)、無遠處轉(zhuǎn)移生存(D-FFS)、總生存(OS)差異無統(tǒng)計學意義。在多因素分析中,同期化療并非3年FFS、LR-FFS、D-FFS、OS的獨立預后因素。然而,在接受IMRT治療及同期化療的患者發(fā)生嚴重急性毒性較接受單純IMRT治療的患者顯著增多;在匹配后,單純放療組和同期放化療組在各項生存終點均無顯著差異(FFS:92.8%vs 91.2%,P=0.801;LR-FFS:95.2%vs 94.4%,P=0.755;D-FFS:96.4%vs 96.3%,P=0.803;OS:98.2%vs 98.9%,P=0.276)�！窘Y論】對于IMRT治療下的中危鼻咽癌患者,同期化療并不能帶來生存獲益,卻顯著增加了急性嚴重毒性的發(fā)生,同期化療是否應作為中危鼻咽癌患者的常規(guī)治療值得進一步的探討。
[Abstract]:[objective] to evaluate the value of concurrent chemotherapy in the treatment of moderately dangerous nasopharyngeal carcinoma (II stage and T3N0M0 stage) in the era of conformal intensity modulation radiotherapy (IMRT). [methods] from October 2009 to December 2012, the Cancer Prevention and treatment Center affiliated to Sun Yat-sen University was used. Four hundred and forty patients with moderate and critical nasopharyngeal carcinoma treated with IMRT or IMRT alone and chemotherapy at the same time were included in the study. The host and tumor factor balanced matching radiotherapy group and simultaneous radiotherapy and chemotherapy group were obtained by tendency score matching. [results] the median follow-up time was 37.3 months. Before matching, patients treated with IMRT alone compared with patients treated with IMRT and chemotherapy at the same time, it was estimated that there was no recurrence survival (LR-FFS) and no distant metastasis survival (D-FFS) in the local area of (FFS), without tumor survival for three years. There was no significant difference in total survival (OS). In multivariate analysis, simultaneous chemotherapy was not an independent prognostic factor for 3 years of FFS,LR-FFS,D-FFS,OS. However, the incidence of severe acute toxicity in patients treated with IMRT and chemotherapy at the same time was significantly higher than that in patients treated with IMRT alone. After matching, there was no significant difference between radiotherapy alone group and radiotherapy and chemotherapy group at each survival end point (FFS:92.8%vs 91.2%, P 鈮，

本文編號：2481025