비인강암의 치료 성적 및 예후 인자
Treatment Outcomes and Prognostic Factors of Nasopharyngeal Carcinoma
2
조회
0
다운로드
0
인용
0
참고문헌
초록
Background and Objectives Nasopharyngeal carcinoma is an uncommon disease that is usually found in the advanced stage becuase its anatomical location makes early detection difficult. Radiation therapy or concurrent chemoradiation therapy is mainstay for treatment of nasopharyngeal carcinoma. We evaluated clinical characteristics and treatment outcomes of nasopharyngeal carcinoma and assessed prognostic factors related to survival. Subjects and Method We retrospectively reviewed medical records of 87 patients who were treated for nasopharyngeal carcinoma from 1994 to 2013. Clinical characteristics, pathologic type, stage, treatment modality, recurrence and survival were investigated. Results The mean follow-up period was 66.7 (12-232) months. Recurrence rates were not significantly different between the radiation therapy group and combined chemoradiation groups in the early stage (27.3% vs. 21.6%, p=0.644) and the advanced stage (21.4% vs. 31.3%, p=0.496). Five-year overall survival and disease free survival rate was 74.0% and 58.9%, respectively. Five-year overall survival rate of the combined chemoradiation therapy group was significantly lower than that of the radiation therapy group (64.4% vs. 94.1%, p=0.001). Distant metastasis was significantly correlated with survival in multivariate analysis. Conclusion In this study, the five-year overall survival rate was better in the radiation therapy group than in the combined chemoradiation group. This might be related to the fact that advanced stage disease was more common in the combined chemoradiation group. Further studies with larger study samples and longer follow-up are necessary to verify these results and determine optimal modalities for the treatment of nasopharyngeal carcinoma. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(3):222-8
Abstract
Background and Objectives Nasopharyngeal carcinoma is an uncommon disease that is usually found in the advanced stage becuase its anatomical location makes early detection difficult. Radiation therapy or concurrent chemoradiation therapy is mainstay for treatment of nasopharyngeal carcinoma. We evaluated clinical characteristics and treatment outcomes of nasopharyngeal carcinoma and assessed prognostic factors related to survival. Subjects and Method We retrospectively reviewed medical records of 87 patients who were treated for nasopharyngeal carcinoma from 1994 to 2013. Clinical characteristics, pathologic type, stage, treatment modality, recurrence and survival were investigated. Results The mean follow-up period was 66.7 (12-232) months. Recurrence rates were not significantly different between the radiation therapy group and combined chemoradiation groups in the early stage (27.3% vs. 21.6%, p=0.644) and the advanced stage (21.4% vs. 31.3%, p=0.496). Five-year overall survival and disease free survival rate was 74.0% and 58.9%, respectively. Five-year overall survival rate of the combined chemoradiation therapy group was significantly lower than that of the radiation therapy group (64.4% vs. 94.1%, p=0.001). Distant metastasis was significantly correlated with survival in multivariate analysis. Conclusion In this study, the five-year overall survival rate was better in the radiation therapy group than in the combined chemoradiation group. This might be related to the fact that advanced stage disease was more common in the combined chemoradiation group. Further studies with larger study samples and longer follow-up are necessary to verify these results and determine optimal modalities for the treatment of nasopharyngeal carcinoma. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(3):222-8
참고문헌 (20)
- Forman D, "Cancer incidence in five continents, Vol. X", pp.953~955 (2014), IARC Scientifi Publications
- Wang Y, "Racial differences in nasopharyngeal carcinoma in the United States", Cancer Epidemiol, 37(6), pp.793~802 (2013)
- Annual report of cancer statistics in Korea in 2012, "Korean Central Cancer Registry", Ministry of Health and Welfare, ~ (2014)
- Teo P, "Prognostic factors in nasopharyngeal carcinoma investigated by computer tomography--an analysis of 659 patients", Radiother Oncol, 23(2), pp.79~93 (1992)
- al-Sarraf M, "Nasopharynx carcinoma: choice of treatment", Int J Radiat Oncol Biol Phys, 33(3), pp.761~763 (1995)
- Kim KH, "Combination of chemotherapy and radiation therapy for nasopharyngeal cancer", Korean J Otolaryngol, 39(1), pp.69~74 (1996)
- Al-Sarraf M, "Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099", J Clin Oncol, 16(4), pp.1310~1317 (1998)
- Venkitaraman R, "Results of combined modality treatment for nasopharyngeal cancer", J Cancer Res Ther, 5(2), pp.102~106 (2009)
- Zhang L, "The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase III randomized trials", BMC Cancer, 10, pp.558~ (2010)
- Chan AT, "Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma:progression-free survival analysis of a phase III randomized trial", J Clin Oncol, 20(8), pp.2038~2044 (2002)
- Kong F, "Assessment of radiotherapy combined with adjuvant chemotherapy in the treatment of patients with advanced nasopharyngeal carcinoma: a prospective study", J BUON, 20(1), pp.206~211 (2015)
- Lee AW, "Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma", J Natl Cancer Inst, 102(15), pp.1188~1198 (2010)
- Cao CN, "Concurrent chemotherapy for T4 classification nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy", PLoS One, 10(3), pp.e0119101~ (2015)
- Kim HS, "Clinical characteristics and treatment results of nasopharyngeal cancer", Korean J Otolaryngol-Head Neck Surg, 41(2), pp.251~256 (1998)
- Sanguineti G, "Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of local and regional control", Int J Radiat Oncol Biol Phys, 37(5), pp.985~996 (1997)
- Jayson Co, "Evidence on effectiveness of intensity-modulated radiotherapy versus 2-dimensional radiotherapy in the treatment of nasopharyngeal carcinoma: Meta-analysis and a systematic review of the literature", Head & Neck, 38(S1), pp.E2130~E2142 (2016), Wiley-Blackwell[DOI]
- Golden DW, "Outcomes of induction chemotherapy followed by concurrent chemoradiation for nasopharyngeal carcinoma", Oral Oncol, 49(3), pp.277~282 (2013)
- "NCCN Clinical Practive Guidelines in Oncology (NCCN guidelines). Version 2" (2013)[URL]
- 공일승, "비인강암의 치료방법에서 Docetaxel과 Platinum을 이용한 유도항암요법의 효과", 대한이비인후과학회지 두경부외과학, 51(1), pp.58~63 (2008), 대한이비인후과학회
- Baker SR, "Prognostic factors in nasopharyngeal malignancy", Cancer, 49(1), pp.163~169 (1982)
