10-Year Results of Therapeutic Ratio by Intensity-Modulated Radiotherapy Versus Two-Dimensional Radiotherapy in Patients with Nasopharyngeal Carcinoma

作者：Lei Chen, Yuan Zhang, Shu-Zhen Lai, Wen-Fei Li, Wei-Han Hu, Rui Sun, Lizhi Liu, Fan Zhang, Hao Peng, Xiao-Jing Du, Ai-Hua Lin, Ying Sun, Jun Ma · 发表于：The Oncologist · 年份：2018 · DOI：10.1634/theoncologist.2017-0577 · 被引用次数：97 · 研究领域：Head and Neck Cancer Studies、Advanced Radiotherapy Techniques、Brain Metastases and Treatment

Abstract Background The purpose of this study was to verify 10-year results of survival and late toxicities and assess the ultimate therapeutic ratio of intensity-modulated radiotherapy (IMRT) versus two-dimensional radiotherapy (2DRT) in patients with nasopharyngeal carcinoma (NPC). Materials and Methods We retrospectively reviewed the data from 1,276 patients with nonmetastatic NPC who received IMRT or 2DRT from January 2003 to December 2006. Results Of the 1,276 patients, 512 were treated with IMRT and 764 with 2DRT. Median follow-up was 115 months. At 10 years, the IMRT group demonstrated significantly better results than the 2DRT group in local failure-free survival (L-FFS; 90% vs. 84%; hazard ratio [HR], 0.57, 95% confidence interval [CI], 0.40–0.81; p = .001), failure-free survival (FFS; 69% vs. 58%; HR, 0.69, 95% CI, 0.57–0.83; p < .001), and overall survival (OS; 75% vs. 63%; HR, 0.62, 95% CI, 0.51–0.77; p < .001). Subgroup multivariate analyses showed that radiotherapeutic technique (IMRT vs. 2DRT) remained an independent prognostic factor for L-FFS in the T1 subgroup (HR, 0.30; 95% CI, 0.11–0.80; p = .02); for FFS in the stage II subgroup (HR, 0.42; 95% CI, 0.24–0.73; p = .002); and for OS in the stage I (HR, 0.20; 95% CI, 0.04–0.96; p = .04), stage II (HR, 0.39; 95% CI, 0.21–0.75; p = .004), and stage IVA–B (HR, 0.74, 95% CI, 0.56–0.98; p = .04) subgroups. The incidence of grade 3–4 temporal lobe necrosis, cranial neuropathy, eye damage, ear damage, ...