ⅣA期鼻咽癌常规放疗448例预后因素分析  

Prognostic factors for survival of 448 patients with stage ⅣA nasopharyngeal carcinoma after conventional radiotherapy

作　　者：林灿峰[1] 李德锐[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院放疗科,广东汕头515031

出　　处：《中华肿瘤防治杂志》2011年第14期1114-1117,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨首程接受常规放射治疗的448例ⅣA期鼻咽癌患者的预后因素。方法:2000-01-01-2004-12-31,首程常规放射治疗ⅣA期(92分期)鼻咽癌448例,其中252例放疗同期联合含顺铂方案的化疗。Kaplan-Meier方法进行单因素分析,Cox比例风险模型进行多因素预后分析。结果:ⅣA期鼻咽癌患者的5年总生存率、局部区域无复发生存率、无远处转移生存率和无瘤生存率分别为52.5%、82.4%、61.9%和51.1%。单因素和多因素分析结果表明,N3是影响总生存率、无远处转移生存率和无瘤生存率的共同预后不良因素。与单纯放疗比较,同期化疗提高了T4N0-2组患者的5年总生存率(66.6%:51.6%;χ2=3.917,P=0.048),但T1-4N3组患者未能从同期化疗中获益。结论:N3分期是影响ⅣA期鼻咽癌总生存率,无远处转移生存率和无瘤生存率的主要不良因素。建议将N3分期患者从ⅣA期中分出另设亚组并在治疗上区别对待。OBJECTIVE： To investigate the prognostic factors of stage ⅣA nasopharyngeal carcinoma（NPC） patients treated with conventional radiotherapy,and evaluate their clinical significance.METHODS： Retrospective analysis was conducted in 448 cases with Stage ⅣA NPC that underwent conventional radiation therapy alone or radiotherapy combined concurrently with platinum-based chemotherapy from 01-01,2000 to 12-31,2004.The 5-year probabilities of overall survival（OS）,local regional recurrence-free survival（LRRFS）,distance metastases-free survival（DMFS） and disease-free survival（DFS） were calculated by the Kaplan-Meier method.The log-rank test statistic allowed detection of statistically significant differences between strata of selected prognostic factors for each endpoint.Multivariate analysis of the factors predicting prognosis were done using Cox regression model.RESULTS：Five-year rates of OS,LRRFS,DMFS and DFS were 52.5%,82.4%,61.9% and 51.1%,respectively.Cox regression analysis revealed that N3 was an independent prognostic factor that adversely affected OS,DMFS and DFS.Concurrent chemotherapy improved the 5 years OS in patients with T4N0-2（66.6% vs 51.6%,χ2=3.917,P=0.048）,but did not significantly increase survival of the patients with N3 stage.CONCLUSIONS： For the NPC patients with stage ⅣA by Chinese staging criteria,N3 is found to be the main predicting factor for survival.It suggestes that patients with N3 should be stratified as a subgroup of IVb,and their future treatments should be refined accordingly.

关 键 词：鼻咽肿瘤/放射疗法 疗效 生存 预后 

分 类 号：R739.63[医药卫生—肿瘤]