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

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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