195例鼻咽癌调强放疗的远期疗效及预后分析  

Long-term outcome and prognostic factor analysis in 195 cases of nasopharyngeal carcinoma treated by intensity-modulated radiotherapy

作　　者：徐丽贤[1] 黄生富[2] 陈亚楠[1] 何侠[2] 张宜勤[2] 王丽君[2] 

机构地区：[1]张家港市第一人民医院肿瘤科,江苏张家港215600 [2]江苏省肿瘤医院放疗科,210009

出　　处：《临床肿瘤学杂志》2015年第9期813-818,共6页Chinese Clinical Oncology

基　　金：2013江苏省卫生厅科研资助项目(Q201302)

摘　　要：目的探讨初治鼻咽癌患者调强放疗(IMRT)的远期疗效并分析预后因素。方法回顾性分析2005年3月至2010年5月收治的195例(根据鼻咽癌2008分期标准,Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为9、24、70、92例)初治鼻咽癌患者采用IMRT的临床诊治情况。收集195例患者的一般资料,采用Kaplan-Meier法进行生存分析,单因素预后分析用Log-rank法,多因素预后分析用Cox回归模型。结果本组患者的随访率达99.5%,随访时间满5年者为150例;5年局部控制率、无远处转移生存率、总生存率和无瘤生存率分别为89.2%、81.9%、76.9%和66.2%。经多因素分析,T分期、N分期以及是否联合化疗是影响5年生存率、无远处转移率和无瘤生存率的独立因素;性别是影响5年无远处转移率和无瘤生存率的独立因素。结论初治鼻咽癌患者采用IMRT能够获得较好的远期疗效和生存质量。除T分期和N分期是影响预后的重要因素外,性别也是预后的重要影响因素,而联合化疗的作用有待进一步的证实。Objective To investigate the long-term outcome and prognostic factors of nasopharyngeal carcinoma patients（ NPC） treated with intensity-modulated radiotherapy（ IMRT）. Methods The clinical results of 195 newly diagnosed NPC patients treated by IMRT from March 2005 to May 2010 were reviewed. According to the standard of NPC 2008 staging system,there were 9 cases of stageⅠ,24 cases of stage Ⅱ,70 cases of stage Ⅲ and 92 cases of stage Ⅳ. Survival analysis was performed with Kaplan-Meier method. Log-rank test was used for evaluating the differences between groups. Multivariate prognostic factors were analyzed by Cox regression model. Results The follow-up rate was 99. 5%. There were 150 patients followed-up more than 5 years. The 5-year local control rate（ LCR）,distant metastasis-free survival rate（ DMFSR）,overall survival rate（ OSR） and disease-free survival rate（ DFSR） were 89. 2%,81. 9%,76. 9% and 66. 2%,respectively. Multivariate analysis showed that the independent prognostic factors for5-year OSR,DMFSR and DFSR were T stage,N stage and the combination with chemotherapy. Gender is an independent prognostic factor for 5-year DMFSR and DFSR. Conclusion NPC treated by IMRT can get good long-term survival with high quality of life. T stage,N stage and gender are important independent prognostic factors for NPC treated by IMRT. The role of combined chemotherapy for locally advanced NPC treated by IMRT needs further investigation.

关 键 词：鼻咽癌 调强放射治疗(IMRT) 预后 

分 类 号：R739.62[医药卫生—肿瘤]