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目的:探索调强放疗(IMRT)联合化疗在治疗Tn 1-2Nn 1Mn 0期鼻咽癌患者中的作用。n 方法:收集2008—2016年间浙江省肿瘤医院和中山大学肿瘤防治中心接受根治性治疗的Tn 1-2Nn 1Mn 0期鼻咽癌患者343例。所有患者均接受IMRT，分为单纯放疗组(RT组)和放化疗组(CRT组)，后者又分为同步放化疗组(CCRT组)、诱导化疗+同步放化疗组(IC+CCRT组)和同步放化疗+辅助化疗组(CCRT+AC组)。采用n Kaplan-n Meier法评价局部区域无复发生存率(LRFFS)、远处无转移生存率(DMFS)、无进展生存率(PFS)、肿瘤特异生存率(CSS)和总生存率(OS)。n Cox模型多因素预后分析。n 结果:303例存活患者的中位随访时间为91个月(49~138个月)。CRT组∶RT组的5年OS、CSS、PFS、LRFFS、DMFS均相近(93.7%∶93.9%、93.7%∶93.9%、89.0%∶87.7%、93.8%∶92.8%、93.8%∶91.2%，均n P>0.05)。Tn 1Nn 1期和Tn 2Nn 1期亚组分析也显示CRT组与RT组的治疗结果均相近(均n P>0.05)。多因素分析显示只有年龄是OS、PFS、CSS和DMFS的独立预后因素，随年龄增长与上述结局呈负相关。CCRT组、IC+CCRT组、CCRT+AC组与RT组的治疗结局均未给患者带来生存获益，且上述3种联合治疗方式之间的疗效也相近(均n P>0.05)。n 结论:Tn 1-2Nn 1Mn 0期鼻咽癌患者接受单纯IMRT获得了满意的治疗效果，预后与联合化疗相当。但未来是否可在Tn 1-2Nn 1Mn 0期人群中取消化疗仍需要前瞻性随机对照临床试验的进一步证实。n “,”Objective:To evaluate the efficacy of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for treating patients with Tn 1-2Nn 1Mn 0 nasopharyngeal carcinoma (NPC).n Methods:343 patients diagnosed with Tn 1-2Nn 1Mn 0 NPC in Zhejiang Cancer Hospital and Sun Yat-sen University Cancer Center from January 2008 to December 2016 were recruited in this study. All patients received IMRT and divided into the radiotherapy (RT) and chemoradiotherapy (CRT) groups. Patients in the CRT group were further assigned into the concurrent chemoradiotherapy (CCRT), induction chemotherapy+ CCRT (IC+ CCRT) and CCRT+ adjuvant chemotherapy (AC) groups. Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) were estimated by n Kaplan-n Meier method. Multivariate prognostic analysis was performed by n Cox models.n Results:The median follow-up time for surviving patients (303/343) was 91(range: 49-138) months. The 5-year OS, CSS, PFS, LRFFS, and DMFS rates in the CRT group were not superior to those of the RT group (93.7%: 93.9%, 93.7%: 93.9%, 89.0%: 87.7%, 93.8%: 92.8%, 93.8%: 91.2%, all n P>0.05). No significant difference was found in treatment outcomes of patients with Tn 1Nn 1 or Tn 2Nn 1 NPC between two groups (all n P>0.05). In multivariable analyses, only age was an independent prognostic factor for OS, PFS, CSS and DMFS, and negative correlation was found between them. No survival benefits were achieved in the CCRT, IC+ CCRT, CCRT+ AC and RT groups, and no significant differences were found in clinical efficacy among the three combined (alln P>0.05).n Conclusions:IMRT alone yields comparable clinical efficacy to CRT in treating patients with Tn 1-2Nn 1Mn 0 NPC. However, whether CT can be eliminated in the Tn 1-2Nn 1Mn 0 population still needs further confirmation by prospective, randomized and controlled clinical trials.n