鼻咽癌调强放疗临床预后因素的研究

发布时间：2018-03-31 06:39

本文选题：鼻咽肿瘤/放疗　切入点：调强放射治疗　出处：《新疆医科大学》2011年硕士论文

【摘要】：目的:本文通过回顾性分析临床资料,对鼻咽癌调强放疗条件下的预后相关因素进行分析,筛选出与生存相关的临床因素和具有独立预后意义的指标;从而为鼻咽癌的治疗提供更好的临床依据。方法:收集2004年1月～2006年8月期间,在新疆肿瘤医院经过病理和CT/MRI检查确诊的,并进行了三维适形调强放射治疗的初治非转移性鼻咽癌患者137例,所有病例具有完善的临床资料,根据鼻咽癌92福州分期系统进行分期。采用Kaplan-Meier方法计算总生存率、无复发生存率、无远处转移生存率、无瘤生存率,用log-rank检验对14项可能影响预后的临床因素做单因素分析,然后用Cox风险比例模型做多因素分析。P0.05认为差异有统计学意义。结果:1,3,5年总生存率分别为98.5%,90.3%,74.6%,无复发生存率分别为97.0%,81.9%,66.7%;无远处转移生存率分别为:96.3%,80.5%,56.0%;无瘤生存率分别为:95.6%,76.9%,43.8%。单因素分析显示T分期、N分期、92福州临床分期、颅底骨质破坏、颅神经损伤、咽后淋巴结转移、联合化疗、疗终残留、总放疗时间、贫血与否等对预后的影响有统计学意义;而多因素分析中仅有N分期、颅神经损伤、联合化疗、疗终残留、总放疗时间为影响鼻咽癌独立的预后因素。结论:鼻咽癌调强放疗后N分期、颅神经损伤、联合化疗、疗终残留、总放疗时间是影响预后最主要因素。
[Abstract]:Objective: to analyze the prognostic factors of patients with nasopharyngeal carcinoma (NPC) under intensity modulated radiotherapy (IMRT) by retrospective analysis of clinical data, and to screen out the clinical factors associated with survival and independent prognostic indicators. Methods: from January 2004 to August 2006, the patients were diagnosed by pathology and CT/MRI in Xinjiang tumor Hospital. 137 patients with primary non-metastatic nasopharyngeal carcinoma were treated with three dimensional conformal intensity modulated radiotherapy. All the patients had perfect clinical data and were staging according to the 92 Fuzhou staging system of nasopharyngeal carcinoma. The overall survival rate was calculated by Kaplan-Meier method. The recurrence free survival rate, distant metastasis survival rate and tumor free survival rate were analyzed by univariate analysis of 14 clinical factors that might affect the prognosis by log-rank test. Cox risk ratio model was used to do multivariate analysis. P0.05 and the difference was statistically significant. Results the overall 5-year survival rate was 98.5% and 90.33%, respectively. The recurrence free survival rate was 97.0% and 81.9%, respectively. The distant metastasis-free survival rate was 80.556%. The tumor-free survival rate was 97.0%. The tumor free survival rate was 90.0%. The survival rate was 97.0%. The distant metastasis-free survival rate was 80.556.0%. The tumor-free survival rate was 90.0%. The single factor analysis showed that T stage was divided into N stage and Fuzhou clinical stage. The effects of skull base bone destruction, cranial nerve injury, retropharyngeal lymph node metastasis, combined chemotherapy, residual therapy, total radiotherapy time, anemia or not on prognosis were statistically significant. Conclusion: the N stage, cranial nerve injury, combined chemotherapy, residual therapy and total radiotherapy time are the most important factors affecting the prognosis of nasopharyngeal carcinoma.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

【相似文献】