临床颈部淋巴结阴性鼻咽癌患者放射治疗预后因素分析

发布时间：2018-10-07 20:49

【摘要】：目的:分析临床N0期鼻咽癌患者临床资料及生存情况,并探讨其预后因素。方法:回顾性分析1989-05-01-2009-12-31汕头大学医学院附属肿瘤医院放疗科627例临床颈部淋巴结阴性(N0期)鼻咽癌患者的临床资料。所有患者治疗前均行颅底鼻咽部CT扫描。采用60 Coγ线或直线加速器6MV X射线进行治疗,常规分割,连续放疗。采用面颈联合野照射DT36~40Gy,然后改用双耳前野加双上颈切线野照射。生存率分析采用Kaplan-Meier方法,Log-rank法检验差异性,Cox风险比例模型进行多因素分析。结果:627例临床颈部淋巴结阴性鼻咽癌患者5年总生存率为78.6%,无病生存率为68.9%,疾病相关生存率为79.9%,局部无失败生存率为81.4%,区域无失败生存率为95.9%,局部区域无失败生存率为78.5%,无远处转移生存率为88.4%;10年总生存率为66.6%,无病生存率为55.9%,疾病相关生存率为70.3%,局部无失败生存率为72.8%,区域无失败生存率为91.9%,局部区域无失败生存率为68.8%,无远处转移生存率为85.2%。作为首次治疗的首发失败事件,单纯局部失败率为16.6%(104/627),区域淋巴结失败率为2.4%(15/627),远处转移率为8.6%(54/627)。多因素分析结果显示,T分期是影响N0期鼻咽癌患者总生存的独立因素。男性、T晚期和贫血者无病生存率较低。结论:N0期鼻咽癌患者有较好的预后,局部失败是治疗失败的首要原因,T分期是影响总生存率的预后独立因素,男性、T分期和贫血是影响无病生存率的独立预后因素。
[Abstract]:Objective: to analyze the clinical data and survival status of patients with stage N 0 nasopharyngeal carcinoma (NPC) and to explore its prognostic factors. Methods: the clinical data of 627 patients with cervical lymph node negative nasopharyngeal carcinoma (N0 stage) were retrospectively analyzed in the Department of radiotherapy, affiliated Cancer Hospital, Shantou University Medical College, 1989-05-01-2009-12-31. All patients underwent CT scan of nasopharynx before treatment. The patients were treated with 60 Co 纬-ray or 6MV X-ray, conventional fractionation and continuous radiotherapy. DT36~40Gy, was irradiated with the combined facial and neck fields, and then was irradiated by the anterior field and the tangent field of the upper neck. Survival rate was analyzed by Kaplan-Meier method and Log-rank test. Results the 5-year overall survival rate was 78.6, the disease-free survival rate was 68.9, the disease-related survival rate was 79.9, the local failure free survival rate was 81.4, the regional non-failure survival rate was 95.9, and the regional non-failure survival rate was 95.9. The survival rate was 78.5%, the survival rate of distant metastasis was 88.4, the overall survival rate of 10 years was 66.6%, the disease-free survival rate was 55.9%, the disease-related survival rate was 70.33%, the local failure free survival rate was 72.8%, the regional failure free survival rate was 91.9%, the local area failure free survival rate was 68.8%. The survival rate of distant metastasis was 85.2%. As the first failure event, the local failure rate was 16.6% (104 / 627), the regional lymph node failure rate was 2.4% (15 / 627), and the distant metastasis rate was 8.6% (54 / 627). Multivariate analysis showed that T stage was an independent factor for the survival of N 0 NPC patients. The disease-free survival rate was lower in men with advanced stage T and anemia. Conclusion the patients with stage N 0 nasopharyngeal carcinoma have a good prognosis. Local failure is the primary reason for failure of treatment. T stage is an independent prognostic factor affecting the overall survival rate, while male T stage and anemia are independent prognostic factors affecting the disease-free survival rate.
【作者单位】：汕头大学医学院附属肿瘤医院放疗科;梅州市人民医院放疗科;
【分类号】：R739.63

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