放射治疗时间延长对调强放射治疗联合化学治疗的鼻咽癌患者的影响

Effect of prolonged radiation treatment time on survival in nasopharyngeal carcinoma patients treated with IMRT combined with chemotherapy

目的探讨放射治疗时间(RTT)延长对调强放射治疗(IMRT)联合化学治疗的鼻咽癌患者生存率的影响。方法回顾性分析629例鼻咽癌患者资料,全部患者均接受IMRT联合化学治疗。Kaplan-Meier法比较分析RTT延长对生存率的影响,Cox多因素分析患者预后。结果 629例鼻咽癌患者RTT为37~59(中位数44)d,RTT>44 d鼻咽癌患者生存率较RTT≤44 d者差(HR=1.88,95%CI 1.12~3.15,P=0.014),远处转移风险有增高趋势,但差异无统计学意义(P=0.069)。多因素分析显示,RTT延长是影响鼻咽癌患者生存的独立因素(HR=1.04,95%CI 1.01~1.08,P=0.021)。结论鼻咽癌患者RTT延长(>44 d)将降低患者生存率。

Objective To evaluate the effect of prolonged radiation treatment time （ RTT） upon the survival of nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy （IMRT） com-bined with chemotherapy. Methods Clinical data of 629 patients diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. All enrolled patients received IMRT combined with chemotherapy. The influence of prolonged RTT upon the survival of patients was assessed by Kaplan-Meier survival analysis. Clinical progno-sis was evaluated by Cox regression analysis. Results The RTT for 629 nasopharyngeal carcinoma patients ranged from 37 to 59 d with a median of 44 d. Compared with patients treated with RTT 〉44 d,the overall sur-vival of patients treated with RTT 〉 44 d was significantly lower （ HR = 1.88, 95% CI 1.12-3.15 , P= 0.014）,and the risk of distant metastasis was slightly higher without statistical significance （P = 0. 069 ） . Cox regression analysis demonstrated that RTT was an independent risk factor of overall survival of nasopharyngeal carcinoma patients （HR = 1.04, 95% CI 1.01-1.08 , P = 0.021）. Conclusion Prolonged RTT （〉44 d） can decrease the survival of patients with nasopharyngeal carcinoma.