调强放疗(IMRT)是一种广泛接受的鼻咽癌(NPC)治疗方法,但它不可避免地会带来辐射相关的并发症,并严重影响生活质量(QoL)。内窥镜鼻咽切除术(ENPG)已成功地在局部复发的NPC进行。但很少有研究评估其在早期NPC中的应用。本研究旨在评估ENPG联合低剂量放疗(LDRT)在T1-2鼻咽癌中的可行性和安全性。
我们从2013年6月至2016年9月招募了37例新诊断的局限性T1-2鼻咽癌患者,自愿接受ENPG+LDRT。同时,收集132例接受IMRT治疗的T1-2鼻咽癌患者的数据,并将其作为对照组.生存结果,比较两组的QoL评分和晚期RT相关后遗症。
经过54个月的中位随访,ENPG+LDRT组仅1例患者伴肝转移死亡。5年总生存率,无远处转移生存率,ENPG+LDRT组局部无复发生存率和局部无复发生存率分别为97.3%,97.3%,100%和100%,与对照组无统计学差异(97.7%,90.2%,95.5%,97.0%,分别,所有P>0.05)。与IMRT组相比,ENPG+LDRT表现出更好的QoL和较低的晚期RT相关后遗症,包括听力损失(53.8%vs27.0%,P=0.005),口干症(46.2%对24.3%,P=0.023)和吞咽困难(25.8%vs8.1%,P=0.024)。
ENPG+LDRT提供了令人满意的生存结果,改善了T1-2期鼻咽癌患者的QoL,降低了后遗症的发生率。
Intensity-modulated radiotherapy (IMRT) is a widely accepted therapy for nasopharyngeal carcinoma (NPC), but it inevitably brings out radiation-related complications and seriously affects the quality of life (QoL). Endoscopic nasopharyngectomy (ENPG) has been successfully conducted in locally recurred NPC, but few studies evaluated its application in early NPC. This study aims to assess the feasibility and safety of ENPG combined with low-dose radiotherapy (LDRT) in T1-2 NPC.
We recruited 37 newly diagnosed localized T1-2 NPC patients who voluntarily accepted ENPG +LDRT from June 2013 to September 2016. Meanwhile, the data of 132 T1-2 NPC patients treated with IMRT were collected and used as control group. The survival outcomes, QoL score and late RT-related sequelaes were compared between the 2 groups.
After a median follow-up of 54 months, only 1 patient in ENPG+LDRT group died along with hepatic metastases. The 5-year overall survival, distant metastasis-free survival, local relapse-free survival and regional relapse-free survival in ENPG+LDRT group were 97.3%, 97.3%, 100% and 100%, which were not statistically different from the control group (97.7%, 90.2%, 95. 5%, 97.0%, respectively, all P > 0.05). In comparison with IMRT group, ENPG+LDRT exhibited better QoL and less rate of late RT-related sequlaes including hearing loss (53.8% vs 27.0%, P = 0.005), xerostomia (46.2% vs 24.3%, P = 0.023) and dysphagia (25.8% vs 8.1%, P = 0.024).
ENPG+LDRT provided satisfactory survival outcomes, and improved the QoL and reduced the incidence of sequelae for T1-2 NPC patients.