侵犯颅底的头颈部恶性肿瘤的预后分析  

Analysis on the prognosis of cases with head and neck tumors involving the skull base

作　　者：王双乐[1] 江远仕[1] 李创伟[1] 杨楚[1] 林炘[1] 杨冬涛[1] 陈恩河[1] 

机构地区：[1]广东省汕头市中心医院中山大学附属汕头医院耳鼻咽喉-头颈外科,515031

出　　处：《中国中西医结合耳鼻咽喉科杂志》2007年第4期271-273,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨侵犯颅底的头颈部恶性肿瘤的预后相关因素。方法1997年1月～2005年12月收治的24例侵犯颅底的头颈部恶性肿瘤患者,采用手术为主、结合放化疗的综合治疗方案。应用Kaplan-Meier法计算累积生存率,并以Cox回归模型进行预后的多因素分析。结果全组患者3、5年生存率分别为71.3%、62.1%;年龄(P=0.0273)、侵犯颅底解剖区域(P=0.0001)、病理分级(P=0.0251)及有无复发(P=0.0011)均是影响预后的单项危险因素;多因素分析显示,仅有侵犯颅底解剖区域(P=0.0118)是影响预后的独立因素。结论侵犯颅底的头颈部恶性肿瘤患者,所侵犯的颅底解剖区域对预后有重要意义,同时有前、侧颅底侵犯者预后较差。Objective To investigate the factors associated with the prognosis of cases with head and neck tumors involving the skull base. Methods Included in this study were 24 cases with head and neck tumors involving the skull base, treated in our Hospital from 1,1997 to 12,2005. These cases were treated by a synthetic therapy mainly composed of operation, combined with radiotherapy and chemotherapy as well. Then, they were evaluated on their survival rate by the formulae of Kaplan-Meier and on their prognosis by Cox＇s proportional hazard model through a multivariate analysis. Results The survival rates of 3-year and 5-year were 71.3 % and 62.1% for this group of cases respectively, with the significant factors affecting the prognosis of these cases in the single-factor analysis being age （P = 0.0273）, the involved region at the skull base by the lesion （ P = 0.0001 ）, pathological staging （ P = 0.0251 ） and with or without local lesion reoccurrence （ P = 0.0011）.However,only the involved region at the skull base by the lesion （P = 0.0118） was the independent factor affecting the prognosis of these cases as shown in the multivariate analysis. Conclusions For the tumor cases with their lesion involving the region of the skull base, the given region at the skull base involved by the lesion is the most significance for them,with the poor prognosis for those with their lesion of head and neck tumor involving the anterior lateral-skull base.

关 键 词：头颈部肿瘤 颅底 综合疗法 预后 

分 类 号：R739.91[医药卫生—肿瘤]