鼻咽癌放疗预后影响因素的COX 分析

 目的探讨鼻咽癌患者放射治疗的独立预后因素，建立个体预后的预测模型，为临床鼻咽癌患者的个体化治疗提供参
考依据。方法分析113例经病理确诊为低分化鳞癌、首次接受根治性放疗且未进行化疗等综合治疗的鼻咽癌患者的预后因
素，采用字2检验进行单因素分析，将有意义的统计学变量纳入COX 回归模型进行多因素分析，并建立个体预后指数（PI）公式。
结果本组病例5 年生存率为50.4%。单因素分析显示，年龄、T 分期、N 分期、临床分期、颅底受侵、颅神经受侵、放疗剂量、体
力状况（PS）评分与鼻咽癌放疗的预后相关。多因素分析显示，年龄、T 分期、N 分期、颅底受侵是鼻咽癌放疗的独立预后因素。根
据COX分析结果，推导PI公式如下：PI=0.046*（年龄）+0.767*（T分期）+0.623*（N 分期）+0.859*（有无颅底受侵）。结论年龄、
T分期、N 分期、有无颅底受侵是鼻咽癌患者放疗的独立预后因素，PI 值是反映鼻咽癌患者预后的量化指标。

COX Analysis of Prognostic Factors in Radiotherapy for Nasopharyngeal Carcinoma

Objective To investigate the independent prognostic factors of radiation therapy in nasopharyngeal carcinoma （NPC）patients，
and to establish an individual prognosis prediction model of NPC patients for individualized clinical treatment. Methods Prognostic factor of
113 NPC patients who were pathologically diagnosed as poorly differentiated squamous cell carcinoma，and received radical radiotherapy for
the first time but not chemotherapy or other comprehensive treatment yet，would be analyzed by Chi-square （X2）test for univariate analysis.
Statistically significant variables would be put into the COX regression model for multivariate analysis. The personal prognostic index（PI）
formula would be established with the result of COX regression model. Results The patients’5-year survival rate was 50.4%. Univariate
analysis showed that age，T stage，N stage，clinical stage，skull base invasion，cranial nerve involvement，radiation dose，performance status
score were associated with the prognosis of NPC radiotherapy. Multivariate analysis showed that age，T stage，N stage，skull base invasion were
independent prognostic factors of NPC radiotherapy. According to the results of COX analysis，PI formula is as followsPI = 0.046 *（Age）+
0.767 *（T stage）+0.623 *（N stage）+0.859 *（with or without skull base invasion）. Conclusion Age，T stage，N stage，with or with-
out skull base invasion are independent prognostic factors of NPC Radiotherapy. PI value is the quantitative indicator which can reflect the
prognosis of patients with nasopharyngeal carcinoma.