期刊
EUROPEAN JOURNAL OF CANCER
卷 51, 期 17, 页码 2587-2595出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2015.08.006
关键词
Nasopharyngeal carcinoma; Intensity-modulated radiotherapy (IMRT); Conventional two-dimensional radiotherapy (2D-CRT); Survival; Retrospective study
类别
资金
- New Century Excellent Talents in University [NCET-12-0562]
- Sun Yat-sen University Clinical Research 5010 Program [201310]
- National Natural Science Foundation of China [81201747]
- Guangdong Provincial Natural Science Foundation of China [S2013020012726, S2012040006323, 2014A030313023]
- Open Foundation of State Key Laboratory of Oncology in South China [HN2013-07]
- National High Technology Research and Development Program of China [2012AA02A501]
Background: To evaluate the survival benefit of intensity-modulated radiotherapy (IMRT) compared with conventional two-dimensional radiotherapy (2D-CRT) in nasopharyngeal carcinoma (NPC) using a large cohort with long follow-up. Methods: We retrospectively analysed 7081 non-metastatic NPC patients who received curative IMRT or 2D-CRT from February 2002 to December 2011. Results: Of the 7081 patients, 2245 (31.7%) were administered IMRT, while 4836 (68.3%) were administered 2D-CRT. At 5 years, the patients administered IMRT had significantly higher local relapse-free survival (LRFS), loco-regional relapse-free survival (LRRFS), progression-free survival (PFS) and overall survival (OS) (95.6%, 92.5%, 82.1% and 87.4%, respectively) than those administered 2D-CRT (90.8%, 88.5%, 76.7% and 84.5%, respectively; p < 0.001). The distant metastasis-free survival (DMFS) was higher for IMRT than 2D-CRT, with borderline significance (87.6% and 85.7%, respectively; p = 0.056). However, no difference was observed between IMRT and 2D-CRT in nodal relapse-free survival (NRFS; 96.3% and 97.4%, respectively; p = 0.217). Multivariate analyses showed that IMRT was an independent protective prognostic factor for LRFS, LRRFS and PFS, but not NRFS, DMFS or OS. Conclusions: IMRT provided an improved LRFS, LRRFS and PFS in both the early and advanced T classifications and overall stage for non-disseminated NPC compared with 2D-CRT. However, no significant advantage was observed in NRFS, DMFS or OS when IMRT was used. (C) 2015 Elsevier Ltd. All rights reserved.
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