局部晚期鼻咽癌IMRT同步化疗预后因素分析  

Prognostic factors for patients with locally advanced nasopharyngeal carcinoma after concurrent IMRT and chemotherapy

作　　者：刘红燕 路泽军 方恒虎 杨平 温居一[1,2] Liu Hongyan;Lu Zejun;Fang Henghu;Yang Ping;Wen Juyi(Naval Clinical College of Anhui Medical University,Anhui 230032,China;Department of Oncology,the Sirth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]安徽医科大学海军临床学院,合肥230032 [2]中国人民解放军总医院第六医学中心肿瘤科,北京100048

出　　处：《中华转移性肿瘤杂志》2021年第1期37-43,共7页Chinese Journal of Metastatic Cancer

摘　　要：目的探讨局部晚期鼻咽癌(LA-NPC)患者IMRT同步化疗后影响预后因素。方法收集2010-2019年间解放军总医院第六医学中心肿瘤科收治的136例LA-NPC患者临床资料,所纳入患者均采用同步放化疗,分析各因素对LA-NPC患者总生存(OS)和无进展生存(PFS)的影响。Log-rank检验进行单因素预后分析,Cox回归进行多因素预后分析。使用"rms"R包绘制列线图。结果中位随访时间为56个月(10~98个月)。全组患者1、3、5年OS率分别为97.1%、85.9%、70.2%,1、3、5年PFS率分别为84.5%、64.5%、50.2%。多因素分析显示LDH浓度≥178 U/L、颅底受侵、顺铂累积剂量<200mg/m^(2)、N_(3)期、EGFR表达阳性患者OS越短(均P<0.05);LDH浓度≥178U/L、颅底受侵、顺铂累积剂量<200mg/m^(2)的患者PFS越短(均P<0.05)。将多因素分析有预后意义的变量构建预后模型,模型对1、3、5年OS预测效能分别为0.91、0.9、0.8,对1、3、5年PFS预测效能分别为0.82、0.78、0.78。结论LDH、颅底受侵、顺铂累积剂量、N分期、EGFR阳性可能作为评估LA-NPC患者预后指标。Objective The paper aims to investigate factors that affect the prognosis in patients with locally advanced nasopharyngeal carcinoma(LA-NPC)after concurrent IMRT and chemotherapy.Methods Clinical data from 136 patients with LA-NPC were collected at the Department of Oncology,the Sixth Medical Center of PLA General Hospital from 2010 to 2019.All patients were treated with concurrent radio-chemotherapy.Then,we analyzed the effects of potential factors on overall survival(OS)and progression-free survival(PFS)for patients with LA-NPC.Log-rank test was performed for univariate analysis.Cox regression analysis was performed for multivariate analysis.Two nomograms were plotted by using rms package in R.Results The median follow-up time was 56 months(10-96 months).The 1-,3-and 5-year OS rate were 97.1%,85.9%and 70.2%,respectively.The 1-,3-,and 5-year PFS rate were 84.5%,64.5%and 50.2%,respectively.Multivariate analysis showed that those participants with shorter OS had LDH concentration≥178U/L,skull destroyed,cisplatin cumulative dose<200mg/m^(2),N_(3) stage and positive EGFR expression(P<0.05).Participants with shorter PFS had LDH concentration≥178U/L,skull destroyed,cisplatin cumulative dose<200mg/m^(2)(P<0.05).According to the results,a prognostic model was constructed for predicting the OS.The predictive efficiency for 1-,3-,and 5-year OS were 0.91,0.9 and 0.8,respectively.A prognostic model was constructed for predicting the PFS.The predictive efficiency for 1-,3-,and 5-year PFS were 0.82,0.78 and 0.78,respectively.Conclusions Our results suggest that LDH,skull destroyed,cisplatin cumulative dose,N stage and positive EGFR expression might be used as prognostic factors associated with poor OS or PFS in patients with LA-NPC.

关 键 词：鼻咽癌 同步放化疗法 预后 预后模型 

分 类 号：R73[医药卫生—肿瘤]