低发病率人群中鼻咽癌放疗后的失败模式：一项DAHANCA研究

文献信息

中文摘要

背景： 鼻咽癌（NPC）在许多人群中并不常见。大多数现有临床证据来自流行地区，在这些地区，EB病毒（EBV）相关亚型占主导地位。我们分析了来自丹麦这一低发病率环境的基于人群队列中的失败模式。
方法： 通过丹麦头颈肿瘤研究组（DAHANCA）数据库识别2000年至2018年间接受根治性治疗的NPC患者，并随后进行验证。
结果： 我们识别出331例患者。任何失败的5年累积发生率为31.1%，局部区域失败为16.9%，远处失败为14.2%。远处失败几乎仅发生于局部晚期疾病（I期：0%；II期：4.2%；III期：21.1%；IVa期：19.4%）。EBV阳性（29.7%）与EBV阴性（32.0%）肿瘤之间的任何失败率相当。
结论： 在这一低发病率人群中，NPC原发放疗后失败的可能性不因EBV状态而异。远处失败主要局限于局部晚期分期的患者。

英文摘要

BACKGROUND: Nasopharyngeal carcinoma (NPC) is uncommon in many populations. Most existing clinical evidence comes from endemic areas, where Epstein-Barr virus (EBV)-associated subtypes predominate. We analyzed patterns of failure in a population-based cohort from Denmark, a low-incidence setting.
METHODS: Patients with NPC treated with curative intent between 2000 and 2018 were identified through the Danish Head and Neck Cancer Study Group (DAHANCA) database and subsequently validated.
RESULTS: We identified 331 patients. The 5-year cumulative incidence of failure was 31.1% for any failure, 16.9% for locoregional failure, and 14.2% for distant failure. Distant failure occurred almost exclusively in locally advanced disease (Stage I: 0%; II: 4.2%; III: 21.1%; and IVa: 19.4%). Rates of any failure were comparable between EBV-positive (29.7%) and EBV-negative (32.0%) tumors.
CONCLUSIONS: In this low-incidence population, the likelihood of failure after primary radiotherapy for NPC did not differ by EBV status. Distant failure was largely confined to patients with locally advanced stages.