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ID:33003662
大小:1.06 MB
页数:32页
时间:2019-02-18
《调强适形放疗对比常规二维放射治疗对鼻咽癌疗效的影响》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、07级硕士学位论文调强适形放疗对比常规-二维放射治疗对鼻咽癌疗效的影响patientstreatedwithIMRT.Apartofpatientsin2D··CRTgroupreceivedX··raysimulation,theothersreceivedCTsimulation.Aboostportalwasperformedifnecessary.Mostofthelocallyadvancedpatientsreceivedneoadjuvant,concomitant,oradjuvantchemotherapyusingvariousregime
2、nsofcytotoxicdrugs(allcisplatin-based).Thepretreatmentandtreatmentcharacteristicsbetweenthetwogroupswerecomparedusingthe贮test.Allthepatientsinthe2D—CRTgroupweresubgroupedintothosereceivingX—raysimulationandthosereceivingCTsimulation,andtheT3/4-stagedpatientsinthe2D-CRTgroupwerefurth
3、ersubgroupedintothosereceivinganadditionalboostdoseandthosewhodidnot.Thensubgroupanalysesweredone.SurvivalbenefitWascomparedbetweentwogroups.TheKaplan-Meierproduct-limitmethodWasusedinthecalculationofthesurvivalanalysis.Thestatisticalsignificanceofdifferenceamongsurvivalcurveswasana
4、lyzedusingthelog-ranktest.MultivariateanalyseswiththeCoxproportionalhazardsmodelwereusedtotesttheindependentsignificance.Results:Therewerenosignificantdifferencesinthehostfactors,histologicalcategories,tumorfactors,andchemotherapybetweentheIMRTand2D—CRTgroupsHowever,significantlymor
5、epatientswithstageT3-4diseaseinthe2D·CRTgroupthanintheIMRTgrouphadreceivedadditionalboosttreatments(22.9%VS.1.5%,P<0.001).ThepatternsoffailureintheIMRTand2D-CRTgroupsweresimilar.Distantmetastasisastheonlysiteoffailurewasthemostcommonincidence,followedbylocalfailurealone.The5-ylocalr
6、elapse-freesurvival(LRFS),nodalrelapse·freesurvival(NR_vS),distantmetastasis-freesurvival(DMFS),anddisease-freesurvivalrate(DFS)fortheIMRTand2D—CRTgroupwere92.7%VS.86.8%p。O.007),97.0%VS.95.5%(旷O.353),84.O%VS.82.6%p=O.395),and75.9%VS.71.4%够=o.088),respectively.ImprovementinLRFSwithIM
7、RTtreatmentWasobserved,whichWasstatisticallysignificantforTlstagedpatientsbetweenthetwogroups(94.4%VS.100%,respectively;P=0.016).ThetwogroupsexhibitedsimilarNRFSandDMFS.AtrendofimprovementinDFSWasobservedwithreachingamarginalstatisticalsignificance.Multivariateanalysesshownthattheha
8、zardratio(HR)ofloca
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