影响鼻咽癌预后因素分析

发布时间：2018-08-29 07:59

【摘要】：鼻咽癌是我国常见的恶性肿瘤之一,在头颈部恶性肿瘤中占首位。其病变首发于鼻咽粘膜上皮,向上可侵及颅底,向下可转移到颈部淋巴结,临床表现复杂多变,易被患者及医务人员忽略及误诊、漏诊。放射治疗为目前首选治疗手段。近年来,国内外分子生物学、细胞遗传学、免疫学、放射生物学、物理学等基础医学迅速发展,为临床制订鼻咽癌综合治疗方案提供了保障。随着治疗方法的不断改进,鼻咽癌的治疗效果已有明显提高。本研究对487名住院鼻咽癌患者进行随访,探讨各种因素对患者生存率的影响。本研究选取487例鼻咽癌患者,男性369例,女性118例,男女比例为3.13:1;最小患病年龄为7岁,最高患病年龄为81岁,患者中位患病年龄为48岁。患者均接受放射治疗,并或接受化学治疗。结果显示,男性患者的5年生存率明显低于女性;各年龄组之间5年生存率均无统计学差异;不同TNM分期及临床分期患者的5年生存率有统计学差异;T、N及临床分期越高,生存率越低。而鼻咽区放射治疗剂量对鼻咽癌预后也有一定的影响,但无统计学差异。常规治疗组和三维适形治疗组比较,三维适形治疗组5年生存率明显提高。同步放化疗比诱导化疗、辅助化疗结合放射治疗、单纯放射治疗的模式,5年生存率均明显提高。通过对影响鼻咽癌预后的相关因素进行多因素Logistic回归分析,显示,性别,疾病分期及治疗技术和放化疗联合治疗方法与鼻咽癌的预后密切相关,本研究将为鼻咽癌的临床治疗提供有意义的参考。
[Abstract]:Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in China. Its first lesion is nasopharynx mucosal epithelium, which can invade skull base up and transfer down to cervical lymph node. Its clinical manifestation is complicated and changeable, which is easy to be neglected and misdiagnosed by patients and medical staff. Radiotherapy is the first choice at present. In recent years, molecular biology, cytogenetics, immunology, radiobiology, physics and other basic medicine have developed rapidly at home and abroad. With the improvement of treatment method, the therapeutic effect of nasopharyngeal carcinoma has been improved obviously. In this study, 487 inpatients with nasopharyngeal carcinoma were followed up to explore the influence of various factors on the survival rate. In this study, 487 patients with nasopharyngeal carcinoma (NPC) were selected, 369 males and 118 females, the ratio of males to females was 3.13: 1, the minimum age was 7 years old, the highest age was 81 years old, the median age of the patients was 48 years old. All patients received radiotherapy or chemotherapy. The results showed that the 5-year survival rate of male patients was significantly lower than that of females, there was no significant difference in 5-year survival rate among different age groups, and the 5-year survival rate of patients with different TNM stages and clinical stages was significantly higher than that of female patients. The lower the survival rate. The radiotherapy dose in nasopharyngeal area also affected the prognosis of nasopharyngeal carcinoma, but there was no statistical difference. The 5-year survival rate of three-dimensional conformal therapy group was significantly higher than that of 3-d conformal therapy group. Compared with induction chemotherapy, adjuvant chemotherapy combined with radiotherapy, radiotherapy alone, 5-year survival rate was significantly improved. Multivariate Logistic regression analysis showed that sex, disease stage, treatment techniques and combined radiotherapy and chemotherapy were closely related to the prognosis of nasopharyngeal carcinoma. This study will provide a valuable reference for the clinical treatment of nasopharyngeal carcinoma.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

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