鼻咽癌放化疗后骨转移的治疗及预后分析  

Prognostic analysis of bone metastasis in patients with nasopharyngeal carcinoma after radiochemotherapy

作　　者：杨保庆[1] 杨玲玲[1] 梁家义[1] 王仁生[2] 康敏[2] 

机构地区：[1]钦州市第一人民医院/广西医科大学第十附属医院肿瘤三区,广西钦州535099 [2]广西医科大学第一附属医院放疗科,广西南宁530021

出　　处：《现代肿瘤医学》2016年第17期2709-2712,共4页Journal of Modern Oncology

基　　金：广西壮族自治区卫生厅自筹经费青年基金项目(编号:Z2012864)

摘　　要：目的:分析鼻咽癌放化疗后骨转移的治疗疗效及预后因素。方法:回顾性分析2003年-2011年在钦州市第一人民医院接受鼻咽癌放化疗后5年内发生骨转移的126例患者的治疗及预后。Kaplan-Meier法计算生存率,Log-rank法行单因素预后分析,Cox回归模型行多因素预后分析。结果:5年随访率为98.4%。全部患者1、2、3、5年生存率分别为69.8%、50.0%、34.9%、15.9%。年龄、性别、治疗前T分期、治疗前N分期、治疗前2D-CRT或IMRT放疗模式,对患者骨转移后1、2、3、5年生存率无影响(P>0.05)。骨转移数目≤3个与骨转移>3个,1、2、3、5年生存率比较,差异有统计学意义(P<0.05);单纯骨转移与骨转移合并其他脏器转移,1、2、3、5年生存率比较,差异有统计学意义(P<0.05);放化疗为主的治疗与化疗为主的治疗比较,1、2、3、5年生存率比较,差异有统计学意义(P<0.05)。多因素分析显示骨转移数目>3个、骨转移合并其他脏器转移、化疗为主的综合治疗模式是影响预后的因素(P=0.000)。结论:鼻咽癌治疗后骨转移灶数目≤3个、无其他脏器转移、放化疗为主的综合治疗模式是疗效显著的因素。Objective：To analyze the prognostic and treatment effect of bone metastasis in patients with nasopharyngeal carcinoma（ NPC） after radiochemotherapy.Methods：A retrospective analysis was performed on the prognosis of 126 NPC patients who had bone metastases after radiochemotherapy（ within five years） in The First People＇s Hospital of Qinzhou from 2003 to 2011.The Kaplan-Meier method was used to calculate survival rates,Log-rank test was used for univariate prognostic analysis,Cox regression model was used for multivariate prognostic analysis.Results：The 5-year follow-up rate was 98.4%.The 1-,2-,3-and 5-year overall survival rates for all patients were69.8%,50.0%,34.9% and 15.9%.Age,gender,T stage,N stage and 2D-CRT or IMRT were no independent prognostic factors for the 1-,2-,3-and 5-year survival rates（ P〉0.05）.The 1-,2-,3-and 5-year survival rates for the patients with not more than 3 bone metastases and the patients with more than 3 bone metastases the differences were significant（ P〈0.05）.The 1-,2-,3-and 5-year survival rates for the patients with simple metastases and the patients with other metastaticsites the differences were significant（ P〈0.05）.The 1-,2-,3-and5-year survival rates for the patients by the main radiochemotherapy and the patients by the main chemotherapy the differences were significant（ P〈0.05）.The multivariate analysis showed that more than 3 bone metastases,other metastaticsites,the main chemotherapy were adverse prognostic factors（ P = 0.000）.Conclusion：Patients with not more than 3 bone metastases,without other metastaticsites,the main radiochemotherapy have better survival than those with more than 3 bone metastases and other metastaticsites.

关 键 词：鼻咽肿瘤 放化疗 骨转移 预后 

分 类 号：R739.6[医药卫生—肿瘤]