246例鼻咽癌患者治疗疗效及晚期反应分析

目的探讨鼻咽癌患者治疗疗效、晚期反应及其影响因素.方法以246例在苏州大学附属第一医院肿瘤放疗科经病理确诊且随访资料完整的鼻咽癌患者为样本进行回顾性分析,采用Kaplan-Meier法计算生存率,log rank法进行生存率组间比较,COX回归分析鼻咽癌患者预后的影响因素,采用Logistic回归分析法分析患者远期不良反应的影响因素.结果随访率为94.6％,1、3、5年生存率分别为97.97％ 、81.82％、67.85％；无进展生存率分别为83.33％、70.00％、39.29％.单因素分析结果显示影响鼻咽癌治疗生存率的预后因素包括年龄(x2=6.604,P=0.010)、T分期(x2=3.670,P=0.050)、N分期(x2=19.658,P=0.001)、临床分期(x2=4.626,P=0.031).COX多因素回归分析结果显示影响鼻咽癌远期疗效的独立预后因子为年龄和临床分期.Logistic回归分析结果显示,年龄、康复时间是影响鼻咽癌患者晚期反应的因子.结论年龄小、临床分期早是鼻咽癌综合治疗后获得长期生存的主要因素.年龄小、康复时间长的患者晚期反应发生率较小.

Curative effects and late phase reactions of nasopharyngeal carcinoma treated with radiotherapy in 246 cases

Objective To analyze the curative effects, late phase reactions and their prognostic factors of nasopharyngeal carcinoma (NPC) treated with radiotherapy. Methods Retrospective analysis was made for 246 cases of NPC which were confirmed by pathological diagnosis and with complete follow-up data in the first affiliated hospital of Soochow university. K-M method was used for analysis of survival rate and the log rank method was used to compare the survival between groups. Cox regression was used for analysing the prognostic factors. Logistic regression was used for analysing the factors which affect the late phase reactions. Results The follow-up rate was 94.6％. The 1-year, 3-year, 5-year overall survival (OS) were 97.97%, 81.82%, 67.85%. The 1-year, 3-year, 5-year progression-free survival (PFS) were 83.33%, 70.00%, 39.29% respectively. Age (χ2=6.604, P=0.010), T stage (χ2=3.670, P=0.050), N stage (χ2=19.658, P=0.001) and the clinical stage (χ2=4.626, P=0.031) were the prognostic factors for the OS. Cox multivariate analysis showed that the independent prognostic factors for the OS were clinical stage and age. Logistic regression analysis showed that the independent prognostic factors for the late phase reactions were age and rehabilitation time. Conclusion The main factors for the long term survival of NPC patients after radiotherapy are early TNM stage and young age. Patients with younger age and longer rehabilitation time have lower incidence of late phase reactions.