放疗联合TPF方案诱导化疗对鼻咽癌患者预后的影响因素分析  

Multivariate analysis of prognostic makers in patients with nasopharyngeal carcinoma intreatment of radiotherapy combined with induction chemotherapy

作　　者：刘杰杰[1] 李姝娜[2] 王燕[1] 时亚伟[1] 朱丽华[1] 吴朝阳[1] 

机构地区：[1]江苏大学附属人民医院肿瘤放疗科,江苏镇江212002 [2]江苏大学附属人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第10期937-940,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：观察放疗联合TPF方案诱导化疗对鼻咽癌患者预后影响的多因素分析。方法：回顾性分析2006-01-2013-12期间收治的鼻咽癌患者144例,予以放疗联合TPF方案诱导化疗。观察放疗联合TPF方案诱导化疗患者的生存分析,并运用单因素和多因素方法观察年龄,性别,临床分期,甲胎蛋白（AFP）、癌胚抗原（CEA）、乳酸脱氢酶（LDH）、同型半胱氨酸（Hcy）、尿酸、NK细胞比例、T细胞比例、糖类抗原对生存时间的影响。结果：截止末次随访,失访9例,其随访率达93.75%;随访时间37~88个月,平均（54.67±17.17）个月。单因素分析显示年龄、临床分期、LDH、NK细胞比例和T细胞比例是鼻咽癌患者的独立预防因子（P〈0.01）,COX回归模型多因素分析发现年龄、临床分期和LDH为影响鼻咽癌预后的强危险因子（P〈0.01）,而NK细胞比例和T细胞比例为影响预后的保护因子（P〈0.01）。结论：放疗联合TPF方案诱导化疗对鼻咽癌的疗效显著,年龄,临床分期和LDH影响预后的重要危险因子,NK细胞比例和T细胞比例是影响预后的保护因子。Objective： To observe the therapeutic effect of radiotherapy combined with TPF in patients with nasopharyngeal carcinoma （NPC） and to explore the influencing factors on prognosis of NPC. Method： A retro- spective analysis of 144 patients with nasopharyngeal carcinoma receiving radiotherapy combined with chemothera- py, from January 2006 to December 2011, was conducted. The survival analysis in patients with nasopharyngeal carcinoma were performed. The impact of age, sex, clinical stage, alpha-fetoprotein（AFP） ,carcinoembryonic anti- gen（CEA） ,lactate dehydrogenase （LDH）, homocysteine （Hey）, uric acid, NK cell proportion, T cell propor- tion,Carbohydrate antigen on survival time was observed with univariate and multivariate methods. Result.. By the last follow-up, 9 cases were lost . The follow-up rate was 93.75 percent and the average follow-up time were 54.67±17.17（37~88） months. The age, clinical stage, LDH, proportion of T cells and NK cells were independ- ent factor in patients with NPC with univariate analysis （P〈0.01）. COX regression multivariate analysis revealed that age, clinical stage and I.DH were strong risk factor affecting prognosis （P〈0.01） and the proportion of NK cells and T cells were protective factors （P〈0.01）. Conclusion：Radiotherapy combined with TPF is more effective than radiotherapy alone in patients with nasopharyngeal carcinoma . Age, clinical stage and LDH may adversely influence the disease prognosis, and NK cells and T cell proportion may act as protective factors.

关 键 词：鼻咽癌 放疗 化疗 因素分析 预后 

分 类 号：R739.6[医药卫生—肿瘤]