鼻咽癌预后因素的临床研究

目的 :通过MRI成像特点研究鼻咽癌的预后因素。方法 :对 58例经病理证实的鼻咽癌患者行首程放射治疗并做MRI检查 ,原发灶给予中位剂量 70Gy( 60～ 75Gy) ,生存统计采用Kaplan Meier法及Logrank检验 ,多因素分析采用Cox逐步回归模型。结果 :全组中位生存时间 56 0个月 ,1、3、5年生存率分别为 98 3%、76 8%、36 6%。单因素和多因素分析显示影响生存的是头痛、颅神经症状及颈淋巴结 (MRI≥ 1cm)。结论 :鼻咽癌的独立预后因素是头痛、颅神经症状和颈淋巴结肿大 ,而MRI显示的颅底骨及咽后淋巴结受累并不影响预后

The Clinical Study of Prognostic Factors of Nasopharyngeal Carcinoma

Objective To stduy the significant prognosticators in nasopharyngeal carcinoma (NPC)by MRI.Methods From March 1993 to March 1996,58 patients were received prime radiotherapy for NPC.All of them were proved in pathology and checked up by MRI.The total dose to the primary tumor was 60-75 Gy(median,70 Gy).Kaplan Meier and Log rank test and Cox stepwise regression model were used to evaluate the significance of prognostic variables in the survival.Results The overall median survival period was 56 months,and 1,3 and 5 year actuarial survivals were 98 3%,76 8% and 36 6%,respectively.Univariate and multivariate analysis showed headache,cranial nerve symptomes and cervical nodal metastasis(Criteria for involved lymph nodes included a lymph node size of 10 mm or more)were significant factors influeming survival.Conclusions Headache,cranial nervesymptomes and cervical nodal metastasis are independent prognostic factors.Retropharyngeal lymphadenopathy and skull base invasion proved solely by MRI does not relate to survival.