The failure patterns of early stage nasopharyngeal carcinoma treated by radiotherapy alone

Objective To analyze the failure patterns of early stage nasopharyngeal carcinoma treated by radiotherapy,and the relationship between the failure patterns and clinical factors,and to explore the way to improve the therapeutic efficacy of radiotherapy.Methods The data of 350 patients diagnosed as early stage(T1-2N0-1M0) nasopharyngeal carcinoma and received radical radiotherapy alone were retrospectively analyzed.The 5-year overall survival rate(OS),local regional recurrence-free survival rate(RFS),distant metastasis-free survival rate(DMFS),local regional control rate(LCR) and distant metastasis rate(DMR) were determined.Failure patterns were determined according to the results of local regional recurrence rate(LR) and metastasis rate(MR),meanwhile the clinical features related to failure patterns of radiotherapy were analyzed.The patients were stratified to the T and N stage,and the 5-year RFS and DFS were subsequently calculated.Results The 5-year OS,RFS,DMFS was 82.8%,89.1% and 86.7%,respectively.The 5-year LCR and DMR was 82.6% and 13.1%,respectively.The 5-year OS of T1N0,T2N0,T1N1,T2N1 was 95.3%,88.0%,81.3% and 72.9%,respectively(P0.05).Among a total of 350 patients received radical radiotherapy,96 cases(27.4%) suffered treatment failure,including 61 cases with local regional recurrence,46 with distant metastasis,11 with both local regional recurrence and distant metastasis.Nasal cavity involvement,N staging(92' Fuzhou) and clinical staging threw significant influence on the l local regional recurrence,while N staging and clinical staging threw significant influence on the distant metastasis.RFS and DMFS were significantly different in patients with different T and N stages.Conclusions Local regional recurrence and distant metastasis are the main failure patterns in early stage nasopharyngeal carcinoma having received radiotherapy alone.Patients in T1-2N1 group may have a poor prognosis,and combined treatment is ncessary instead of radiotherapy alone.