吴立洲,王丽君,黄生富.鼻咽癌调强放疗后局部复发的临床分析[J].肿瘤学杂志,2015,21(3):179-184.
鼻咽癌调强放疗后局部复发的临床分析
Clinical Analysis on Local Recurrence After IMRT for Nasopharyngeal Carcinoma
投稿时间:2014-07-16  
DOI:10.11735/j.issn.1671-170X.2015.03.B004
中文关键词:  鼻咽肿瘤  调强放疗  局部复发
英文关键词:nasopharyngeal neoplasms  intensity modulated radiotherapy  local recurrence
基金项目:2013江苏省卫生厅科研项目(Q201302)
作者单位
吴立洲 武警江苏总队医院 
王丽君 江苏省肿瘤医院 
黄生富 江苏省肿瘤医院 
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中文摘要:
      摘 要:[目的] 探讨鼻咽癌调强放疗(IMRT)后局部复发的临床特征。[方法] 回顾分析174例初治鼻咽癌IMRT局控率及11例确诊为局部复发患者的临床特点。[结果] 1、3、5年局部复发率分别为0.6%、5.6%、6.4%。局部复发时间:放疗后11~61个月,其中9例(9/11,81.8%)3年内复发;余2例复发时间分别为53个月、61个月。11例局部复发病例中10例(10/11,90.9%)为原GTV区域野内复发。不同T分期及临床分期之间局部复发无明显差异。11例局部复发患者,7例接受了放疗为主的二程综合治疗,仅1例筛窦边缘复发的患者获得长期无瘤生存;其余6例,1例死于二程放疗后鼻咽大出血,5例均于二程放疗后1年内再复发。[结论] 鼻咽癌IMRT后局部复发率低,局部复发形式以GTV高剂量区野内复发为主;局部复发与T分期及临床分期无明显相关性;复发患者二程调强放疗疗效差。
英文摘要:
      Abstract:[Purpose] To investigate the clinical features of local recurrence of nasopharyngeal carcinoma after intensity modulated radiotherapy(IMRT). [Methods] Local control rate1of 174 cases initially treated with IMRT and clinical characterisitics of 11 cases with local recurrence were analyzed retrospectively. [Results] The 1-,3- and 5-year local recurrence rate was 0.6%,5.6% and 6.4%,respectively. The local recurrence time was 11~61 months after radiotherapy. Of the all 11 local recurrence cases,9 cases recurred (9/11,81.8%) within 3 years and other 2 cases in 53 months and 61 months,respectively. Among the 11 cases with local recurrence,10 (10/11,90.9%) recurred inside the original GTVP. It was showed that there was no significant difference in local recurrence among different T stages and different clinical stages,respectively. For the 11 cases with nasopharyngeal local recurrence,7 cases received comprehensive retreatment based on radiotherapy. Among the 7 cases,there was only 1 case,relapsed on the edge of ethmoid sinus,achieving long-term disease-free survival; however,for the other 6 cases,there was 1 case dying of nasopharyngeal bleeding after re-irradiation and 5 relapsing within 1 year after retreatment. [Conclusion] The local recurrence rate of IMRT for nasopharyngeal carcinoma is low. The location of local recurrence is mainly concentrated in high dose region of GTVP. Local recurrence rate has no significant difference among different T stages or clinical stages. For the recurrence patients,curative effect of re-irradiation by IMRT is poor.
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