鼻咽癌放疗后远处转移的预后研究

发布时间：2018-04-24 16:26

  本文选题：鼻咽癌 + 远处转移　； 参考：《福建医科大学》2011年硕士论文

【摘要】：目的分析鼻咽癌根治性放疗后发生远处转移患者的生存预后因素,同时进一步探讨转移性鼻咽癌治疗后长期生存患者的特征及生存相关因素,为此类型患者的规范治疗及个体化治疗方案的制定提供依据。 方法回顾性分析根治性放疗后发生远处转移的鼻咽癌184例,Kaplan—Meier法计算生存率;Log—rank test对生存率差异进行显著性检验。采用Cox风险比模型进行单因素及多因素分析。对其中长期生存者,分析归纳其特征。 结果全组中位生存12个月,1、2、3年生存率分别为50.6%、30.7%和20.9%,单因素分析发现,放疗后发生转移患者的生存时间与初诊时N分期、初诊时是否化疗、首程放疗结束发生远处转移的时间间隔、转移部位、转移后是否化疗及化疗的周期数、转移后是否行姑息放疗有关。Cox回归分析显示初诊时N分期、转移部位、转移后是否化疗、是否姑息放疗、初治放疗结束到远处转移的时间间隔对于转移性鼻咽癌患者的生存具有独立的预后意义。其中转移性鼻咽癌治疗后长期生存患者的特征为:①放疗结束到发生转移的中位时间≥22月。②转移部位多为单脏器、单病灶,转移灶较小或者多发骨转移病灶分布相对集中。③转移后接受了全身化疗且化疗周期≥4周期。④转移灶(单发或多发)接受了姑息放疗为主的局部治疗。 结论:(1)鼻咽癌放疗后远处转移患者的预后与初治放疗结束到远处转移的时间间隔、转移灶部位、转移灶数目及治疗方式有关;(2)全身化疗和局部姑息放疗是转移性鼻咽癌患者的主要治疗方式。
[Abstract]:Objective to analyze the prognostic factors of patients with distant metastasis after radical radiotherapy of nasopharyngeal carcinoma (NPC), and to explore the characteristics and survival related factors of patients with metastatic nasopharyngeal carcinoma (NPC) after radiotherapy. Therefore, the standard treatment and individualized treatment of the type of patients to provide the basis for the formulation. Methods the survival rate of 184 cases of nasopharyngeal carcinoma with distant metastasis after radical radiotherapy was analyzed retrospectively. The survival rate was calculated by Kaplan-Meier method and Log-rank test was used to test the difference of survival rate. Cox risk ratio model was used to analyze single factor and multi-factor. The characteristics of the long-term survivors are analyzed and summarized. Results the median survival rate for 12 months and 3 years were 50.6% and 20.9%, respectively. Univariate analysis showed that the survival time of the patients with metastasis after radiotherapy was related to the N stage at the first visit and whether the patients were treated with chemotherapy or not. The interval of distant metastasis at the end of first stage radiotherapy, the location of metastasis, the number of cycles of chemotherapy and chemotherapy after metastasis, and whether palliative radiotherapy was performed after metastasis. Cox regression analysis showed that N stage, location of metastasis, and chemotherapy after metastasis. Whether palliative radiotherapy, the time interval between the end of primary radiotherapy and distant metastasis has an independent prognostic significance for the survival of metastatic nasopharyngeal carcinoma. The characteristics of long term survival after treatment of metastatic nasopharyngeal carcinoma were that the median time from the end of 1 radiotherapy to metastasis was more than 22 months, and most of the metastatic sites were single organ and single focus. Patients with small or multiple bone metastases received systemic chemotherapy and chemotherapy cycles 鈮，

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