| 季海峰,黄生富,姚成云.T1~2期鼻咽癌调强放疗后局部复发与临床转归分析[J].肿瘤学杂志,2020,26(10):875-878. |
| T1~2期鼻咽癌调强放疗后局部复发与临床转归分析 |
| Local Recurrence and Outcome of T1~2 Nasopharyngeal Carcinoma after Intensity?鄄modulated Radiotherapy |
| 投稿时间：2020-04-25 |
| DOI：10.11735/j.issn.1671-170X.2020.10.B005 |
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| 中文关键词: 鼻咽肿瘤 T1~2 期 局部复发 挽救治疗 |
| 英文关键词:nasopharyngeal carcinoma T1~2 stage local recurrence salvage therapy |
| 基金项目:江苏省科技厅省重点研发计划（社会发展）（BE2019758） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨T1~2 期鼻咽癌IMRT后局部复发及临床转归。［方法］ 回顾性分析2005—2015年连续收治IMRT初治T1~2期鼻咽癌患者198例，分析复发危险因素、挽救治疗及转归情况。［结果］ T1~2 期鼻咽癌IMRT后1、3、5年局部控制率分别为99.5%、95.9%和94.6%，总生存率分别为 100.0%、96.4%和90.8%。共14例患者出现局部复发，其中rT1~2 12例，复发部位包括咽隐窝7例（50.0%）、顶后壁5例（35.7%）、筛窦2例（14.3%）；复发中位时间36个月（10～125个月）。挽救治疗中位随访36个月，其中7例行二程放疗，有3例再次复发；5例接受微创手术，均无再复发；2例行姑息化疗。6例患者病情进展死亡。［结论］ T1~2 期鼻咽癌IMRT后局部复发率低，二程放疗疗效欠佳，放射后遗症较重。而手术治疗取得较好疗效同时避免了放射性并发症。T1~2 期鼻咽癌也应定期随访，尽早发现局部复发。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the local recurrence and clinical outcome of T1~2 nasopharyngeal carcinoma(NPC) after intensity-modulated radiotherapy(IMRT). ［Methods］ Clinical data of 198 consecutive T1~2 NPC patients treated with IMRT from 2005 to 2015 were retrospectively reviewed. Factors related to local recurrence，salvage treatment and outcome were analyzed. ［Results］ The 1-，3- and 5-year local control rates were 99.5%，95.9% and 94.6%，and the 1-，3- and 5-year overall survival was 100.0%，96.4% and 90.8%，respectively. Fourteen patients had local recurrence，of whom 12 were rT1~2. The recurrence sites were pharyngeal recess(7 cases，50.0%)，the posterior parietal wall(5 cases，55.7%) and the ethmoid sinus(2 cases，24.3%). The median time to recurrence was 36 months(10~125 months). The median follow-up of salvage treatment was 36 months. Seven patients underwent second-course radiotherapy，and 3 patients relapsed. Five patients underwent minimally invasive surgery and no recurrence occurred. Two patients received palliative chemotherapy. Six patients died of progression. ［Conclusion］ T1~2 NPC patients have a low local recurrence rate after IMRT. Second-course radiotherapy is ineffective and the sequelae of radiation therapy are severe. Surgical treatment can improve the curative effect while avoiding radiation complications.T1~2 NPC should also be followed up regularly to detect local recurrence as early as possible. |
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