目的探讨新疆地区鼻咽癌调强放疗(IMRT)的远期疗效及预后因素。方法回顾性分析新疆医科大学附属肿瘤医院2006年-2010年接受全程IMRT放疗的初治无远处转移的141例患者的临床资料,其中18例单纯放疗,123例接受以铂类为基础的化放疗综合治疗。Kaplan-Meier法计算5年总生存率(OS)、无瘤生存率(DFS)、局部控制率(LC)、区域控制率(RC)及无远处转移生存率(DMFS),Log-rank法检验单因素预后分析。结果全组5年OS、DFS、LC、RC、DMFS分别为:81.6%、67.9%、88.6%、92.2%、80.1%。单因素分析表明影响鼻咽癌5年OS的因素有年龄、性别、N分期(χ^211.62、4.45、4.08,P=0.001、0.035、0.043),影响5年DFS的因素有年龄、T分期及临床分期(χ^24.4、4.11、7.8,P=0.036、0.043、0.02)。接受IMRT治疗的鼻咽癌患者放疗反应多为轻、中度。结论 IMRT治疗鼻咽癌可以获得较好的5年OS、LC、RC及DMFS,不良反应多可耐受,年龄、分期为影响预后的主要因素。
Objective To investigate the long term outcomes and prognostic factors of nasopharyngeal carci-noma (NPC) from Xinjiang region treated by intensity-modulated radiotherapy. Methods 141cases newly diagnosed and no distant metastasis NPC patients treated by IMRT in the affiliated Tumor Hospital of Xin-jiang Medical University from Jan. 2006 to Dec. 2008 were reviewed. There were 18 treated by radiothera-py alone, 123 treated by platinum-based chemoradiotherapy. Overall survival (OS), diseage free survival (DFS), local control survival (LC), regional control survival (RC) and distant metastasis-free survival (DMFS) were estimated using the Kaplan-Meier method. Results The 5-year OS, FS, LC, RC and DMFS was 81.6% ,67.9% ,88.6% ,92.2% ,80.1%. Multivariate analysis showed that, age,gender and N stage were the independent prognostic factors for 5-year OS (X^2= 11. 62, 4. 45, 4. 08, P =0. 001, 0. 035, 0.043), age T stage and clinical stages were the independent prognostic factors for 5-year DFS (X^2=4.4, 4.11,7.8, P =0.036,0. 043,0.02). The radiotherapy reaction of IMRT were tolerated. Conclusions IM-RT provided favorable 5-year OS, LC, RC and DMF. The acute and late toxicities were acceptable. Age and stages were the main factor of prognsis.