影响鼻咽癌放射治疗预后因素分析

发布时间：2018-06-22 21:36

本文选题：鼻咽癌 + 预后因素　；参考：《广西医科大学》2012年硕士论文

【摘要】：目的：通过对本院441例鼻咽癌患者进行回顾性分析,探讨影响鼻咽癌放射治疗的预后因素,为临床治疗提供参考。方法：对2003年1月至2007年11月在广西医科大学附属肿瘤医院接受首诊并行根治性放疗的有本院病理确诊的441例鼻咽癌患者,进行回顾性分析病例的年龄、性别、T分期、N分期、临床分期、颅神经损伤、放疗方式、鼻咽部放射剂量、化疗、2003年世界卫生组织(WH0)病理分型等因素对预后的影响。采用Kaplan-Meier方法进行生存率计算,用Log-rank法检验显著性,进行单因素分析,再将有意义的统计学变量纳XCOX回归模型进行多因素分析,当P0.05时认为差异具有统计学意义。结果：(1)441例鼻咽痛患者,1、3、5年的总生存率分别为92%、70%、58%。(2)单因素分析显_／J{,年龄(P=0.008)、T分期(P=0.002)、N分期(P=0.005)、临床分期(P=0.000)、放疗方‘式(P=0.003)、颅神经损伤(P=0.000)是显著的预后因素。2003年WH0炳理分萑lJ(P=0.524)及-{卜角化亚?型(P=0.681),差异L尤统计学意义。本研究进一步分层分析了舁.II冈痂患者应用2003WH0-卤理组织分类重新分型后,比较了相同临床分期及是否化疗与预后的关系,结果显示生存率均无统计学意义。相同临床分期且均为角化性癌未分化型鼻咽癌患者是否化疗与预后的关系,结果显_／J÷生存j率尢统计学意义。(3)多因素分析显示÷,年龄(P=0.001)、颅神经损伤(P=0.011)、放疗方式(P=0.008)是影响鼻咽癌预后的独立因素。结论：年龄、T分期、N分期、临床分期、放疗方式、颅神经损伤与鼻咽癌预后相关；年龄越大、颅神经损伤的鼻咽癌患者预后不佳；调强放射治疗优于后程三维适形放射治疗及常规放射治疗,但本研究调强放射治疗例数太少,需扩大样本量后做进一步验证。2003WH0病理组织分类与鼻咽癌预后无相关性,并且相同临床分期及是否化疗与预后亦无关系；进一步分层分析了相同临床分期且均为非角化性癌未分化型鼻咽癌患者预后与是否化疗无相关性。本组资料成偏态分布,两组资料例数悬殊,因此还需扩大样本量后做进一步研究。
[Abstract]:Objective: to study the prognostic factors of radiotherapy for nasopharyngeal carcinoma (NPC) by retrospective analysis of 441 patients with nasopharyngeal carcinoma (NPC). Methods: from January 2003 to November 2007, 441 patients with nasopharyngeal carcinoma (NPC) who received the first diagnosis and radical radiotherapy in the affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. Clinical stage, cranial nerve injury, radiotherapy, nasopharyngeal radiation dose, chemotherapy, 2003 World Health Organization (WH0) pathological classification and other factors affecting the prognosis. Kaplan-Meier method was used to calculate the survival rate, Log-rank method was used to test the significance, and univariate analysis was carried out. Results: (1) the overall survival rates of 441 patients with nasopharyngeal pain were 92um and 70700.Results: (2) univariate analysis showed that P / J {, age (P0. 008) T stage (P0. 002), clinical stage (P0. 005), radiotherapy formula 'type (P0. 003), cranial nerve injury (P0. 000) were significant prognostic factors. HuanlJ (P0. 524) and-{BK? Type A (P < 0. 681), the difference was statistically significant (P < 0. 681). In this study, we further analyzed the relationship between the same clinical stage, chemotherapy and prognosis by using 2003WH0- halogenated tissue classification in patients with stay.II callus. The results showed that there was no significant difference in survival rate. Relationship between chemotherapy and prognosis in patients with the same clinical stage and undifferentiated carcinoma of keratocytic nasopharyngeal carcinoma. Results the survival rate was statistically significant. (3) multivariate analysis showed that factors such as age (P0. 001), cranial nerve injury (P0. 011) and radiotherapy (P0. 008) were independent factors affecting prognosis of nasopharyngeal carcinoma (NPC). Conclusion: age T stage N stage, clinical stage, radiotherapy mode, cranial nerve injury are related to the prognosis of nasopharyngeal carcinoma, the older the age, the worse the prognosis of nasopharyngeal carcinoma patients with cranial nerve injury. Intensity modulated radiotherapy is superior to late course three-dimensional conformal radiotherapy and conventional radiotherapy. However, there are too few cases of intensity modulated radiotherapy in this study. It is necessary to further verify that there is no correlation between pathological classification of .2003WH0 and prognosis of nasopharyngeal carcinoma. There was no correlation between the prognosis of the patients with the same clinical stage and chemotherapy, and the prognosis of the patients with undifferentiated nasopharyngeal carcinoma (NPC) with the same clinical stage and non-keratinizing carcinoma. The data of this group are skewed and the two groups of data are different in number, so it is necessary to make further study after enlarging the sample size.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.63

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