初治鼻咽癌合并皮肌炎86例临床配对研究  

Clinical Paired Study of 86 Cases with Primary Nasopharyngeal Carcinoma Complicated with Dermatomyositis

作　　者：钟宗良[1] 莫浩元[1] 麦海强[1] 李燕娴[1] 杨婧[1] 曹卡加[1] 郭翔[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心,广东广州510060

出　　处：《中国肿瘤》2012年第3期220-224,共5页China Cancer

基　　金：广东省科技计划资助课题(2011B031800314)

摘　　要：[目的]分析初治鼻咽癌合并皮肌炎患者的临床特点,探讨其放疗疗效、毒副作用及预后因素。[方法]86例鼻咽癌合并皮肌炎患者和单纯鼻咽癌患者(对照组)进行配对研究,Kaplan-Meier法计算生存率,Log-Rank检验比较两组生存差异;Mann-WhinetyU检验比较两组急性及晚期放疗反应发生情况;Cox回归模型对合并皮肌炎组进行预后多因素分析。[结果]合并皮肌炎组1、3、5年总生存率分别为86.9%、70.2%、58.1%,对照组分别为96.4%、81.1%、62.7%,差异无统计学意义(χ2=1.254,P=0.263)。合并皮肌炎患者使用激素治疗无明显生存获益。合并皮肌炎组患者急性放疗反应较对照组严重(P<0.05)。单因素分析显示性别、年龄、TNM分期、T分期、N分期是影响鼻咽癌合并皮肌炎的预后因素,Cox回归模型分析显示性别、TNM分期、化疗是独立预后因素。[结论]鼻咽癌合并皮肌炎患者疗效与单纯鼻咽癌患者相近,但其放疗急性反应较重;性别、TNM分期、化疗是其预后的独立影响因素。[Purpose] To investigate the clinical characteristics,response and toxicity of radiotherapy and prognostic factors of patients with primary NPC complicated with dermatomyositis.[Methods] A paired study of 86 cases with NPC complicated with dermatomyositis and 86 cases with NPC alone （control group） were performed,the survival rate of two groups were calculated by Kaplan-Meier method,and compared by Log-rank test.Acute and chronic adverse effect were compared by Mann-Whinety U test.Prognosis of complicated with dermatomyositis group was analyzed by Cox regression model.[Results]The 1,3,5-year overall survival rate in complicated with dermatomyositis group was 86.9%,0.2% and 58.1%,while those in control group was 96.4%,81.1% and 62.7 % respectively,without significant difference （χ2=1.254,P=0.263）. Patients in complicated with dermatomyositis group with glucocorticoid treatment didn’t show significant survival benefit.The acute side effect of radiotherapy was significantly increased in complicated with dermatomyositis group（P0.05）. Univariate analysis showed that gender,age,TNM staging,T staging and N staging were prognostic factors of patients with NPC complicated with dermatomyositis. Cox regression analysis showed gender,TNM stage and chemotherapy were independent prognostic factors.[Conclusions]The response of the complicated with dermatomyositis group and control group is similar,but the acute side effect in complicated with dermatomyositis group is serious.Gender,TNM staging and chemotherapy are th independent prognostic factors of nasopharyngeal carcinoma complicated with dermatomyositis.

关 键 词：鼻咽癌 皮肌炎 放射治疗 预后 糖皮质激素 

分 类 号：R739.63[医药卫生—肿瘤]