化疗联合放疗治疗T_3N_(0～1)M_0鼻咽癌的预后分析

Analysis of the Prognosis for Patients with Stage T3N0～1M0 Nasopharyngeal Carcinoma Treated by Chemotherapy Combined with Radiotherapy

目的:探讨T3N0～1M0鼻咽癌的治疗模式和预后因子。方法:分析2000年1月4日至2001年11月12日127例T3N0～1M0鼻咽癌患者的临床资料,按照放疗是否联合化疗分为单纯放疗组(A组)90例,放疗联合化疗组(B组)37例。B组病例中,接受诱导化疗18例,接受诱导+同期化疗5例,同期化疗14例。结果:A、B两组5年总生存率(OS)分别为73.4%,72.3%(P>0.05);两组5年癌症相关生存率(CSS)分别为76.4%,72.3%(P>0.05);A、B两组无瘤生存率(DFS)分别为65.5%,71.7%(P﹤0.05)。多因素分析显示放疗联合化疗为DFS有利的独立影响因素。结论:化疗联合放疗能提高T3N0～1M0鼻咽癌的无瘤生存率,但不能延长患者的总生存时间。化疗联合放疗不是T3N0～1M0鼻咽癌的必须治疗模式。

Objective： To investigate the relationship between the therapeutic modality and prognostic factors for the patients with T3N0-1M0 nasopharyngeal carcinoma. Methods： The clinical data from 127 cases of T3N0-1M0 nasopharyngeal carcinoma patients with initial treatment, during the period from January 4th, 2000 to November 12th, 2001, were retrospectively analyzed. The cases were divided into Group A with simple radiotherapy （90） and Group B with the radiation therapy combined with chemotherapy （37）, based on various patients＇ conditions. In group B, inductive chemotherapy was conducted for 18 cases, inductive chemotherapy plus homochronous chemotherapy for 5 and homochronous chemotherapy for 14. Results： The 5-year overall survival （OS） in the groups A and B was 73.4% and 72.3% respectively （P 〉 0.05）; the cancer-correlated survival （CCS） in the 2 groups was 76.4% and 72.3% respectively （P 〉 0.05）; the disease-free survival （DFS） in group A and B was 65.5% and 71.7% respectively （P 〈 0.05）. A multiple analysis showed that the mode of radiation therapy plus chemotherapy was a favorable independent impact factor for DFS. Conclusion： Chemotherapy plus radiotherapy can improve the DFS of patients with T3N0- 1M0 nasopharyngeal carcinoma, but fails to prolong the survival time of the patients. The modality of chemotherapy plus radiotherapy is not the necessary choice in treatment of patients with T3N0-1M0 nasopharyngeal carcinoma.