鼻咽癌治疗后局部复发回顾性研究

发布时间：2018-04-10 03:24

本文选题：治疗失败　切入点：鼻咽肿瘤　出处：《中华肿瘤防治杂志》2017年03期

【摘要】：目的鼻咽癌治疗后局部复发为主要失败模式之一,本研究分析无远处转移鼻咽癌(nasopharyngeal carcinoma,NPC)患者临床特征与治疗后鼻咽局部复发的关系,为指导临床治疗及提高局部控制提供依据。方法收集2000-01-01-2004-12-31汕头大学医学院附属肿瘤医院1 338例病理确诊无远处转移行首程根治性治疗NPC患者临床特征,率的比较采用卡方检验;生存指标、单因素分析采用Kaplan-Meier法;多因素分析采用Cox回归分析。结果治疗后随访5、10和15年复发比例分别为10.4%、11.9%和12.0%,累计鼻咽复发风险分别为12.7%、15.5%和16.6%;中位复发间隔时间为28个月。单因素分析结果表明,鼻咽癌鼻咽复发的危险因素包括放疗剂量、疗程延长、未行化疗、颅底骨破坏、副鼻窦受侵和颅神经损伤。Cox风险比例逐步回归多因素分析结果显示,影响NPC患者鼻咽复发的独立预后不良因素为未行化疗和颅底骨质破坏,P0.05。结论 NPC患者治疗5年后长期随访仍可出现鼻咽复发,提示与NPC患者侵犯部位和生物学行为有关,联合化疗与长期随访策略可能是有效防治措施。
[Abstract]:Objective to analyze the relationship between the clinical features of nasopharyngeal carcinoma (NPC) patients without distant metastasis and the local recurrence of nasopharyngeal carcinoma (NPC) after treatment, so as to provide evidence for guiding clinical treatment and improving local control.Methods the clinical features of 1 338 patients with NPC confirmed pathologically without distant metastasis were collected from January 12 to 31, 2004, the rate of survival was compared by chi-square test, and the survival index was analyzed by Kaplan-Meier method.Cox regression analysis was used for multivariate analysis.Results the recurrence rates were 10.4% and 12.0%, respectively, and the cumulative risk of nasopharyngeal recurrence were 12.715% and 16.60.The median recurrence interval was 28 months.Univariate analysis showed that the risk factors for nasopharyngeal recurrence of nasopharyngeal carcinoma included radiotherapy dose, prolonged course of treatment, no chemotherapy, skull base destruction, paranasal sinus invasion and cranial nerve injury.The independent adverse prognostic factors affecting nasopharyngeal recurrence in NPC patients were no chemotherapy and skull base bone destruction (P0.05).Conclusion after 5 years of treatment, nasopharyngeal recurrence can still occur in patients with NPC, suggesting that the combination of chemotherapy and long-term follow-up may be an effective preventive and therapeutic measure for NPC patients, which may be related to the site of invasion and biological behavior.
【作者单位】：汕头市中心医院肿瘤放疗科;汕头大学医学院附属肿瘤医院放疗科;
【分类号】：R739.63

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