鼻咽癌颈椎破坏的临床特征及预后分析

发布时间：2018-01-19 23:27

本文关键词： 鼻咽癌颈椎侵犯与转移分期预后　出处：《实用癌症杂志》2011年03期 　论文类型：期刊论文

【摘要】：目的分析鼻咽癌颈椎破坏的临床特点、治疗方法和预后,并探讨临床治疗策略的合理性。方法收集42例初次治疗中仅有颈椎破坏的鼻咽癌。根据MRI、PET-CT或CT加骨扫描的结果为:颈椎侵犯的鼻咽癌T4M0期(20例)和仅有颈椎转移的鼻咽癌M1(22例)。回顾性分析比较两者PFS及OS差异的显著性,并单因素生存分析其临床特点、治疗模式与预后的关系。结果中位随访时间为19个月(3~38个月),中位总生存时间为15个月,24例死亡,16例存活,失访2例,两组患者2年总生存率分别为57.1%和36.4%(P=0.173),无疾病进展生存率为42.9%和27.3%(P=0.361)。单因素分析结果得出,对颈椎有破坏的T4M0期鼻咽癌患者,治疗方式、近期疗效、EBV病毒数量及失败模式是其独立预后因素。对仅有颈椎转移的M1期鼻咽癌患者,HBG、PLT、ZPS评分及失败模式是其独立预后因素。结论不同分期(T4M0、M1)颈椎破坏的鼻咽癌者,2年OS总生存率及PFS无疾病进展生存率无显著性差异,但临床治疗近期疗效较好。颈椎有侵犯的T4M0期鼻咽癌患者,治疗方式、近期疗效、EBV病毒数量、失败模式可能是其独立预后因素。仅有颈椎转移M1期鼻咽癌患者,HBG、PLT、ZPS评分及失败模式可能是其独立预后因素。
[Abstract]:Objective to analyze the clinical features, treatment methods and prognosis of cervical destruction in nasopharyngeal carcinoma (NPC), and to explore the rationality of clinical treatment strategy. Methods 42 cases of nasopharyngeal carcinoma with cervical vertebrae destruction were collected according to MRI. The results of PET-CT or CT combined with bone scan were as follows: 20 cases of cervical invasion of nasopharyngeal carcinoma (T4M0) and 22 cases of nasopharyngeal carcinoma (M1) with only cervical metastases. The difference of PFS and OS was analyzed retrospectively. Results the median follow-up time was 19 months, 3 ~ 38 months, and the median survival time was 15 months, 24 patients died. There were 16 cases of survival and 2 cases of lost visit. The 2-year overall survival rate of the two groups was 57.1% and 36.4% respectively (P = 0.173). The progression-free survival rate was 42.9% and 27.3% respectively. The results of univariate analysis showed that the treatment methods and short-term results were effective in patients with stage T4M0 nasopharyngeal carcinoma (NPC) with cervical vertebrae damage. The number and failure pattern of EBV were independent prognostic factors. ZPS score and failure model were independent prognostic factors. Conclusion patients with different stages of cervical spine destruction are nasopharyngeal carcinoma patients with T4M0 / M1. There was no significant difference in 2-year OS survival rate and PFS disease progression survival rate, but the short-term curative effect of clinical treatment was better. In patients with stage T4M0 nasopharyngeal carcinoma with cervical invasion, the treatment mode was short-term. The number of EBV virus and the failure pattern may be the independent prognostic factors, only in the patients with cervical metastatic M1 nasopharyngeal carcinoma (NPC) and the failure model may be the independent prognostic factors.
【作者单位】：南昌大学医学院;江西省肿瘤医院;
【分类号】：R739.63
【正文快照】： 鼻咽癌(nasopharyngeal carcinoma,NPC)是中国及东南亚地区常见的恶性肿瘤之一,病理类型几乎均为低分化鳞癌和未分化癌,其癌细胞95%以上分化不良,恶性程度高,具有强大的侵袭及转移力。在其早期即可见远处侵袭性改变,而远处转移中以骨转移多见,尤其是扁骨转移。而对于颈椎侵犯

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