| OBJECTIVE retrospectively analyze the clinical data of nasopharyngeal carcinoma recurrent patients after intensity-modulated radiotherapy, to investigate the clinical features and regularity of nasopharyngeal carcinoma recurrence after intensity-modulated radiotherapy, that provide the basis for nasopharyngeal carcinoma with intensity-modulated radiotherapy, to further improve the local control rate and survival rate.MATERIALS AND METHODSV Collection the clinical data of 49 nasopharyngeal carcinoma recurrence patients who were from the First Affiliated Hospital of Guangxi Medical University Department of Radiation Oncology from January 2009 to December 2014. To analyze the recurrence time, location, stage, target area, dose and so on.Rank data were analyzed by rank sum test. P<0.05 was statistically analyzed by SPSS 16.0.RESULTR1. The median time to relapse was 20 months, after radiotherapy for 6 to 12 months recurrence cases accounted for 8.2%, for 12 to 18 months recurrence cases accounted for 34.7%, for 18 to 24 months recurrence cases accounted for 22.4%, for 24 to 30 months recurrence cases accounted for 26.5%, for 30～36 months recurrence cases accounted for 2.0%,3 years accumulative recurrence cases accounted for 93.9%,> 3 years recurrence cases accounted for 6.1%.2. Simple local recurrence was 57.1%, simple regional recurrence was 22.4%, the local and regional recurrence was 20.4%. The site of higher invasion probability of local recurrence:petrous apex (60.5%), Clivus (57.9%), sphenoid basal (55.2%), pterygopalatine fossa (47.3%), pterygoid process (44.7%);regional recurrence was 21 (42.8%),57.1% in the second zone, 23.8% in the third zone,9.5% in the fourth zone, and 4.7% in the posterior margin of the parotid region.3.49 patients with recurrence in 2009’UICC/AJCC staging again as follows:Ⅰ 4.1% (2/49), Ⅱ 24.5%(12/49), Ⅲ 26.5%(13/49), Ⅳa 40.8% (20/49), Ⅳb 4.1% (2/49), According to the 2009’UICC/AJCC staging system to review the primary nasopharyngeal carcinoma stage (Primary stage):Ⅱ 6.1%(3/49), Ⅲ 40.8% (20/49), Ⅳa 51.0% (25/49), Ⅳb 2.0%(1/49).By Wilcoxon rank and test to compare the original stage and relapse stage:12.2% (6/49) of patients with recurrence T staging more late than primary T stage, however,51.0%(25/49) of primary T staging more late than recurrence T staging (P= 0.029); 57.1%(28/49) patients with recurrent N staging more early than primary N staging, however,8.2%(4/49) of the primary N staging more early than N staging of recurrence (P=0.001),34.7% of patients relapse N staging with the primary N staging was the same. For total TNM staging,16.3% (8/49) patients relapse stage more advanced than the primary stage, however, 38.8%(19/49) in the primary stage more advanced than recurrence, clinical stage (P< 0.005).4. The In-field recurrence patients has 47 case (simple local recurrence 28 cases, the local and regional recurrence 10 cases, simple regional recurrence 9 cases); The out-field recurrence patients has 2 cases (left parotid posterior recurrence 1 case, left supraclavicular fossa lymph node recurrence 1 case).CONCLUSION1. The median time of nasopharyngeal carcinoma recurrence after intensity modulated radiotherapy was 20 months, and the majority recurrence time was within 3 years.2.Recurrence site after intensity modulated radiotherapy for nasopharyngeal carcinoma, Nasopharyngeal skull base and more common, the regional recurrence is II region.3. The In-field recurrence is the mode of recurrence after intensity modulated radiation therapy. |
PDF Full Text Request