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비인강암의방사선치료결과및생존율에관한예후인자분석 2005 2 1 2005 3 28. :, Tel: 053)250-7665, Fax: 053)250-7984 E-mail: jhkim@dsmc.or.kr

정영연외 2 인 : 비인강암의예후인자분석

정영연외 2 인 : 비인강암의예후인자분석

Carcinoma of the nasopharynx treated by radiotherapy alone: determinants of distant metastasis and survival. Radiother Oncol 1997; 43:53-61 Prognostic value of Chinese race in Nasopharyngeal cancer. Int J Radiat Oncol Biol Phys 2002;54: 752-758 3 Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography. Int J Radiat Oncol Biol Phys 1996;36:291-304 Clinical study of malignant tumors of the nasopharynx. Korean J Otolaryngolo 1989; 32:879-887 Prognostic factors affecting the outcome of nasopharyngeal carcinoma. Jpn J Clin Oncol 2003;33:501-508 Prognostic factors and outcome for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2003;129:794-799 Radiotherapy for nasopharyngeal carcinoma. J of Korean Soc for Ther Rad and Onc 2003;21:269-275 Patterns of failure following radiation with and without chemotherapy in patients with nasopharyngeal carcinoma. Onkologie 2003;26:12-18 Concurrent chemotherapy and radiation therapy for advanced stage carcinoma of the nasopharynx. Int J Radiat Oncol Biol Phys 2000;48:1277-1279 Prognostic features and treatment outcome in patients with nasopharyngeal carcinoma: an experience of 20 years. Anticancer Res 2001;21:1413-1418 Prognostic factor of nasopharyngeal carcinoma: a multivariate analysis. Int J Radiat Oncol Biol Phys 1990;19:1143-1149 Carcinoma of nasopharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Bio Phys 1997; 37:985-996 Radiation therapy of nasopharyngeal carcinoma: prognostic factors based on a 10- year follow-up of 1,302 patients. Int J Radiat Oncol Biol Phys 1989;16:301-305 Nasopharyngeal carcinoma: treatment results with primary radiation therapy. Laryngoscope 1992;102:965-972 Analysis of failures after definitive irradiation for epidermoid carcinoma of the nasopharynx. Cancer 1980;45:2725-2729 Nasopharyngeal carcinomas: analysis of patient, tumor and treatment characteristics determining outcome. Radiother Oncol 2001;61:247-256 An analysis on factors affecting local control and survival in nasopharyngeal carcinoma. J of Korean Soc for Ther Rad and Onc 1999; 17:91-99 Retrospective analysis of 5,037 patients with nasopharyngeal carcinoma treated during 1976-1985: overall survival and patterns of failure. Int J Radiat Oncol Biol Phys 1992;23:261-270 Carcinoma of the nasopharynx: factors affecting prognosis. Int J Radiat Oncol Biol Phys 1992;23: 271-280 Prognostic factors for local control in nasopharyngeal cancer (NPC): analysis by multivariate proportional hazard models. Radiother Oncol 1991; 21:233-239 Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys

정영연외 2 인 : 비인강암의예후인자분석 2002;53:12-22 Stereotactic radiosurgical boost following radiotherapy in primary nasopharyngeal carcinoma: impact on local control. Int J Radiat Oncol Biol Phys 1999;45:915-921 Three-dimensional intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: the University of California-San Francisco experience. Int J Radiat Oncol Biol Phys 2000;48:711-722 Neoadjuvant chemotherapy and radiation therapy compared with radiation therapy alone in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1999;45:901-905 Results of a prospective randomized trial comparing neochemotherapy plus radiotherapy with radiotherapy alone patients with locoregionally advanced nasopharyngeal carcinoma. J Clin Oncol 2001;19:1350-1357 Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregioally advanced nasopharyngeal carcinoma: progression- free survival analysis of a phase III radomized trial. J Clin Oncol 2002;15:20:1968-1970 Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol 2003;21:631-637 Nasopharyngeal carcinomas: an update. Eur J Cancer 2003;39:2121-2135 Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-1317 An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma Department of Radiation Oncology, Keimyung University School of Medicine, Daegu, Korea Purpose: This retrospective study was conducted to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center. According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients (27.9%) were at Stage II, 13 (30.2%) were at Stage III and 18 (41.9%) were at Stage IV. Histopathologically, there were 15 (34.9%) squamous cell carcinomas, 8 (18.6%) nonkeratinizing carcinomas, 17 (39.5%) undifferentiated carcinomas, and 3 (7.0%) lymphoepitheliomas. Among the total 43 patients, 31 patients (72.1%) were treated with only radiation therapy. Neoadjuvant chemotherapy was performed on 7 patients (16.3%) and concurrent chemoradiotherapy was performed on 5 patients (11.6%). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy). The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was 90.7%. The five year overall survival and disease free survival rates were 50.7% and 48.9%, respectively. On the multivariate analysis, the age, T-stage (T 1-3 vs T 4), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p 0.05). The patterns of failure were as follows: local failure only in 3 patients (7.0%), local and systemic failure in 1 patient (2.3%), and distant metastasis only in 11 patients (25.6%). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (T 1-3 vs T 4), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In addition, research for more effective chemotherapeutical regimens and schedules is also needed. Nasopharyngeal carcinoma, Radiation therapy, Survival rate, Prognostic factor