根治性放射治疗后远处转移鼻咽癌的预后研究

目的分析鼻咽癌根治性放疗后发生远处转移患者的生存预后因素,为临床治疗方案的选择提供依据。方法回顾性分析根治性放疗后发生远处转移的鼻咽癌83例,Kaplan-Meier法计算生存率;Log-ranktest对生存率差异进行显著性检验。采用Cox风险比模型进行单因素及多因素分析。结果全组中位生存12个月,1、2、3年生存率分别为51.3%、33.0%和23.8%。单因素分析发现,根治性放疗后远处转移患者的生存时间与初诊时N分期、放疗结束到发生远处转移的时间间隔、转移部位、转移后所行化疗的周期数相关。多因素分析显示初诊时N分期、转移后所行化疗的周期数具有独立的预后意义。结论初诊时N分期对鼻咽癌的总生存有决定性作用,足够有效的化疗有望延长放疗后远处转移患者的生存时间。

Prognostic Analysis of Distant Metastasis from Nasopharyngeal Carcinoma after Radical Radiation Therapy

Objective To study the prognostic factors determining survival of metastatic nasopharyngeal carcinoma following curative radiotherapy.Methods 83 patients with distant metastatic disease from nasopharyngeal carcinoma following curative radiotherapy were studied retrospectively.The survival rate was calculated by Kaplan-Meier.Log-rank test was used to test the differences of survival rate between patient's subgroups.Multivariable analysis was performed using the Cox proportion hazards model.Results The median survival time was 12 months,and the 1-,2-,3-year survival rate were 51.3%,33.0% and 23.8%,respectively.N stage,time to metastasis,site and number of metastatic lesions,cycles of chemotherapy after diagnosis of metastatic were significant prognostic factors in univariate analysis.The N stage and cycles of chemotherapy were independently significant prognostic factors in multivariable analysis.Conclusion Initial N stage was the significant prognostic factor in patients with NPC.Enough and effective chemotherapy may improve the survival of NPC with metastasis.