Abstract

Background

It is still controversial whether intensity-modulated radiotherapy has an obvious advantage over conventional radiotherapy. The purposes of this study were to evaluate prognostic factors in pre-treatment characteristics for nasopharyngeal carcinoma and to compare treatment outcomes in patients who received intensity-modulated radiotherapy and patients who received two-dimensional radiotherapy or three-dimensional radiotherapy.

Methods

We reviewed patients with nasopharyngeal carcinoma who received chemoradiotherapy in our hospital during the period from 2000 to 2017, and we excluded patients who had a history of surgery for nasopharyngeal carcinoma and those who had distant metastases before treatment. A total of 72 patients who were treated by radiotherapy with concurrent chemotherapy were enrolled. All of the patients were irradiated with a total dose of 58–70 Gy. Overall survival, locoregional control and progression-free survival rates were compared in the groups treated by intensity-modulated radiotherapy and two-dimensional/three-dimensional radiotherapy. Propensity score matching was performed to homogenize the two groups.

Results

The median follow-up period was 62.5 months. After propensity score matching, in patients treated with intensity-modulated radiotherapy, the 5-year rate of overall survival, locoregional control and progression-free survival were 73.5, 95.2 and 72.7%, respectively. In patients treated with two-dimensional/three-dimensional radiotherapy, the 5-year rate of overall survival, locoregional control and progression-free survival were 69.1, 67.7 and 51.8%, respectively. There was a significant difference between the groups only in locoregional control. Late toxicities of grade 2 or higher were occurred in 38.5 and 24.2% of the patients treated by two-dimensional/three-dimensional radiotherapy and intensity-modulated radiotherapy, respectively.

Conclusions

Our results suggested that intensity-modulated radiotherapy is more effective than two-dimensional/three-dimensional radiotherapy in patients with nasopharyngeal carcinoma, especially in locoregional control.

中文翻译：

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与常规放疗相比，IMRT 可改善鼻咽癌患者的局部控制：倾向评分匹配分析

摘要

背景

调强放疗是否比常规放疗具有明显优势仍存在争议。本研究的目的是评估鼻咽癌治疗前特征的预后因素，并比较接受调强放疗和接受二维放疗或三维放疗的患者的治疗结果。

方法

我们回顾了2000年至2017年期间在我院接受放化疗的鼻咽癌患者，我们排除了有鼻咽癌手术史和治疗前发生远处转移的患者。共纳入接受放疗联合化疗的患者 72 例。所有患者均接受了 58-70 Gy 的总剂量照射。比较调强放疗组和二维/三维放疗组的总生存率、局部控制率和无进展生存率。进行倾向评分匹配以使两组均质化。

结果

中位随访期为 62.5 个月。倾向评分匹配后，调强放疗患者的5年总生存率、局部控制率和无进展生存率分别为73.5%、95.2%和72.7%。在接受二维/三维放疗的患者中，5 年总生存率、局部控制率和无进展生存率分别为 69.1%、67.7% 和 51.8%。仅在局部区域控制方面，各组之间存在显着差异。在接受二维/三维放射治疗和调强放射治疗的患者中，分别有 38.5% 和 24.2% 的患者发生了 2 级或更高级别的晚期毒性。

结论

我们的研究结果表明，调强放疗比二维/三维放疗对鼻咽癌患者更有效，尤其是在局部控制方面。