Analysis of Changes in Failure Risk Over Time of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma / 中山大学学报(医学科学版)

ABSTRACT

[Objective] This study aims to investigate the changes in risk of disease failure in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) after treatment over time and provide reference for individualized follow-up.[Methods] 556 patients receiving intensity-modulated radiotherapy (IMRT) from 2009 to 2010 were analyzed.The failure free survival (FFS) and annual hazard rates of disease failure were estimated using the life-table method.We also used the difference confidence interval to evaluate the difference between different failure risk rates.[Results] The median follow-up in study was 83 months.A total of 119 patients experienced the treatment failure during the follow-up period.The 5-year failure-free survival rate of the whole cohort was 80.6％ and the curve of failure risk showed an increase in the first two years and a slow decline after two years.The comparison of the rates of failure risk in different stages between the peak year and the subsequent years were as followFor patients with stage Ⅲ,failure risk rate of the second year was significantly 3.2％ higher than that in the fifth year;Rate of the second year was significantly 18.4％ higher than that in the fourth year for patients with stage ⅣB.No significantly difference was found in other results.Additionally,the risks of failure in patients with ⅣB were significantly higher than that in patients with stage Ⅲ in the first two years and in patients with stage ⅣA in the second year.[Conclusion] The curve of failure risk for patients with locoregionally advanced NPC reached a relative peak in the second year.It is recommended that patients with stage Ⅲ maintain a relatively high follow-up frequency within 3-4 years after treatment;Patients in stage ⅣA were not recommended to reduce the frequency of follow-up within 3-5 years;It was recommended that the frequency of follow-up could not be reduced within 2-3 years,and should be given a more intensive follow-up strategy than patients with stage Ⅲ-ⅣA in the first two years.