摘要
Objective:To investigate the efficacy and side effects of concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma after neoadjuvant chemotherapy.Methods:In the prospective study, 100 patients with stage Ⅲ-Ⅳa locally advanced nasopharyngeal carcinoma (except T 3N 0M 0 stage) who met the inclusion criteria were randomly divided into the experimental and control groups using the random number table method. Patients in both groups were treated with neoadjuvant chemotherapy using TPF (paclitaxel liposome, cisplatin, and 5-fluorouracil) regimen for 2 cycles. At 2 weeks after chemotherapy, concurrent chemoradiotherapy plus nimotuzumab targeted therapy was given in the experimental group, and concurrent chemoradiotherapy was delivered in the control group. The main observation index was the distant metastasis-free survival (DMFS) rate. Log-rank test and multivariate Cox regression analysis were used. Results:The objective remission rate and complete remission rate in the experimental and control groups were 100% vs. 98% ( P=1.000) and 92.0% vs. 80% ( P=0.084). The 3-year DMFS in the experimental and control groups were 91.4 % vs. 76.1 % ( P=0.043). The 3-year progression-free survival (PFS), locoregional recurrence-free survival (LRFS) and overall survival (OS) in two groups were 87.3 % vs. 74.1 % ( P=0.097), 94.5 % vs. 85.6 % ( P=0.227) and 90.5% vs. 85.2% ( P=0.444). Subgroup analysis showed that patients with age<60 years ( HR=0.34, 95% CI=0.12-0.94, P=0.037), neutrophil-to-lymphocyte ratio (NLR)≤4 ( HR=0.34, 95% CI=0.13-0.89, P=0.028) received concurrent chemoradiotherapy plus nimotuzumab obtained better PFS. Multivariate analysis showed that NLR was an independent risk factor for disease progression ( HR=5.94, 95% CI=1.18-29.81, P=0.030) and distant metastasis ( HR=13.76, 95% CI=1.52-124.36, P=0.020). Conclusions:Compared with concurrent chemoradiotherapy alone, concurrent chemoradiotherapy combined with nimotuzumab after neoadjuvant chemotherapy can significantly increase DMFS rate for patients with locally advanced nasopharyngeal carcinoma. The incidence of side effects is similar in two groups. Concurrent chemoradiotherapy plus nimotuzumab after neoadjuvant chemotherapy may be a preferred treatment strategy for locally advanced nasopharyngeal carcinoma.
摘要
Objective:To investigate the research status and development trend of radiotherapy for lung cancer in recent 10 years through the bibliometric analysis of relevant literature.Methods:Taking the core collection of Web of Science as the data source, combined with the visualization function of Cite Space software, bibliometric methods were adopted to analyze the literature publication, distribution of journals, authors, institutions and countries, the literature co-citation, keyword co-occurrence and clustering of the lung cancer radiotherapy research from 2010 to 2019.Results:In recent 10 years, the amount of literature published in this field has been on the rise year by year. International Journal of Radiation Oncology Biology Physics was the journal with the largest number of publications. The authors and organizations with the most articles were all from the United States. Stereotactic radiotherapy has become a research hot spot in this field, and the combination of immunotherapy and stereotactic radiotherapy may become a novel development trend in the future. Conclusions:In the past 10 years, the research on radiotherapy has been developing steadily at home and abroad, forming a certain research direction and development trend. Some core institutions and core authors have appeared. However, international exchange and cooperation remain to be strengthened probably due to the unbalanced development of global radiotherapy technology.
摘要
Objective@#To analyze the failure patterns and related factors of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) in Xiangxi.@*Methods@#107 patients with nasopharyngeal carcinoma without distant metastasis were selected from December 2012 to June 2015 in the first affiliated hospital of Jishou University. Locoreginal recurrence-fee survival rate (LRFS), distant metastasis-free survival rate (DMFS) and progression-free survival (FPS) rate were collected. The survival rate was analyzed by Kaplan-Meier method, univariate analysis was analyzed by Logrank method, and multivariate analysis was analyzed by Cox regression.@*Results@#Tumor progression occurred in 40 cases of 107 patients with nasopharyngeal carcinoma. Among them, 14 cases(13.1%) had local recurrence and 33 cases (30.8%) had distant metastasis. Univariate analysis showed that there was significant difference in LRFS between different ages and T staging (P<0.05). There was significant difference in DMFS and PFS between different gender, ages, diabete history, smoking history, T staging, N stage, clinical stage and treatment mode (P<0.05). Multivariate analysis showed that age and T staging were independent prognostic factors for LRFS. Age, T staging and N staging were independent prognostic factors for DMFS. Age, diabetes, T staging, and N staging were independent prognostic factors for PFS (P<0.05).@*Conclusions@#Distant metastasis is still the main model of treatment failure of NPC. Age, T staging and N staging before treatment are the significant prognostic factors.
摘要
Objective To analyze the failure patterns and related factors of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) in Xiangxi.Methods 107 patients with nasopharyngeal carcinoma without distant metastasis were selected from December 2012 to June 2015 in the first affiliated hospital of Jishou University.Locoreginal recurrence-fee survival rate (LRFS),distant metastasis-free survival rate (DMFS) and progression-free survival (FPS) rate were collected.The survival rate was analyzed by Kaplan-Meier method,univariate analysis was analyzed by Logrank method,and multivariate analysis was analyzed by Cox regression.Results Tumor progression occurred in 40 cases of 107 patients with nasopharyngeal carcinoma.Among them,14 cases(13.1％) had local recurrence and 33 cases (30.8％) had distant metastasis.Univariate analysis showed that there was significant difference in LRFS between different ages and T staging (P ＜ 0.05).There was significant difference in DMFS and PFS between different gender,ages,diabete history,smoking history,T staging,N stage,clinical stage and treatment mode (P ＜ 0.05).Multivariate analysis showed that age and T staging were independent prognostic factors for LRFS.Age,T staging and N staging were independent prognostic factors for DMFS.Age,diabetes,T staging,and N staging were independent prognostic factors for PFS (P ＜0.05).Conclusions Distant metastasis is still the main model of treatment failure of NPC.Age,T staging and N staging before treatment are the significant prognostic factors.