■分析初诊鼻咽癌(NPC)远处转移患者接受调强放疗(IMRT)诱导化疗的疗效和预后因素。
■回顾性分析2008年3月至2018年11月在本中心接受铂类诱导化疗后接受确定性IMRT伴或不伴同步或辅助化疗治疗新诊断的远处转移性鼻咽癌的129例患者。41例患者接受了转移部位的局部治疗。Kaplan-Meier方法用于估计生存率,使用Log-rank检验和Cox比例风险模型来确定总生存期(OS)的独立预后因素。
■共有66名患者死亡(中位随访时间,51.5个月)。中位总生存期(OS)为54.2个月(范围,7-136个月),和1年,2年,3年,5年总生存率为88.0%,71.0%,58.0%,和47.0%。多因素分析发现,治疗前血清乳酸脱氢酶(SLDH)>180U/L,化疗周期<4,M1期细分(M1b,单个肝转移和/或不包括肝脏的多个转移;和M1c,多发性肝转移)。M1a的5年操作系统费率,M1b和M1c分别为62.6%,40.4%和0%,分别。
■含铂的诱导化疗联合IMRT似乎有利于延长一些初次诊断时同步转移的NPC患者的生存期。预测OS的独立因素是治疗前SLDH,化疗周期数,和M1子类别。需要前瞻性临床试验来确认结果。
UNASSIGNED: To analyze the therapeutic effect and prognostic factors of nasopharyngeal carcinoma (
NPC) patients with distant metastases at initial diagnosis receiving induction chemotherapy with intensity-modulated radiotherapy (IMRT).
UNASSIGNED: A total of 129 patients who underwent platinum-based induction chemotherapy followed by definitive IMRT with or without concurrent or adjuvant chemotherapy for newly diagnosed distant metastatic
NPC in our center between March 2008 and November 2018 were retrospectively analyzed. 41 patients underwent local therapy for metastatic sites. Kaplan-Meier method was used to estimate survival rates, Log-rank test and Cox proportional hazards model were used to figure out independent prognostic factors of overall survival (OS).
UNASSIGNED: A total of 66 patients had been dead (median follow-up time, 51.5 months). The median overall survival (OS) time was 54.2 months (range, 7-136 months), and the 1-year, 2-year, 3-year, 5-year overall survival rates were 88.0%,71.0%,58.0%, and 47.0%. Multivariate analysis found that the factors correlated with poor overall survival were pre-treatment serum lactate dehydrogenase (SLDH) >180U/L, chemotherapy cycles<4, and M1 stage subdivision (M1b, single hepatic metastasis and/or multiple metastases excluding the liver; and M1c, multiple hepatic metastases). The 5-year OS rates for M1a, M1b and M1c were 62.6%,40.4% and 0%, respectively.
UNASSIGNED: Platinum-containing induction chemotherapy combined with IMRT seemed to be advantageous to prolong survival for some
NPC patients with synchronous metastases at initial diagnosis. The independent factors to prognosticate OS were pre-treatment SLDH, number of chemotherapy cycles, and M1 subcategories. Prospective clinical trials are needed to confirm the result.