72例转移性鼻咽癌的预后分析

目的 探讨转移性鼻咽癌预后的相关因素.方法 分析2004年9月至2008年9月我科确诊的72例转移性鼻咽癌患者的预后因素,其中男性62例,女性10例,中位年龄50岁(28-81岁).比较单发转移组(14例)与多发转移组(58例)、转移合并局部复发组(14例)和转移无局部复发组(58例)以及综合治疗组(61例)和单纯支持治疗组(11例)间的生存率.Kaplan-Meier法计算生存率,log-rank检验各组生存率,Cox逐步回归模型进行多因素分析.结果 转移合并局部复发组1年、2年生存率14.3%、1.1%,中位生存期8.2个月,较转移无局部复发组生存率及中位生存期(38.5%、20.3%、11.6m)低,P<0.05.单发转移组与多发转移组1年、2年生存率分别为47.5%、20.0%与37.5%、12.5%,P>0.05.综合治疗组与支持治疗组1年、2年生存率分别为47.2%、16.1%与40.0%、12.0%,P>0.05.两组间生存率无统计学差异.多因素分析显示性别(P=0.026)、合并局部复发(P=0.020)是影响转移性鼻咽癌预后的独立因素.结论 转移性鼻咽癌以化疗为主的综合治疗并未提高总生存率.性别、有合并局部复发是影响转移性鼻咽癌预后的独立影响因素.

Prognosis analysis for 72 cases of nasopharyngeal carcinoma(NPC)with distant metastasis

Objective:To investigate prognostic factors of NPC patients with distant metastasis.Methods: A total of 72 NPC patients with distant metastasis after primary treatment were analysed in our department from September 2004 to September 2008,including 62 wale and 10 wfemale,with a median age of 50(range,28-81).Compared the survival rates of single metastasis lesion group(14 cases)and multiple metastasis lesion group(58 cases),metastasis accompanied by local recurrent diseases group(14 cases)and only distant metastasis group(58 cases),comprehensive treatment group(61 cases)and supportive care group(11 cases).The survival rates were calculated by Kaplan-Meier method and compared by log-rank test.Clinically multivariate prognosis analysis was performed by Cox regression model.Results: The 1-,2-,year survival rates of metastasis accompanied with local recurrent diseases group were 14.3%,1.1%,the median survival time was 8.2 months,which was lower than the group of patients with distant metastasis alone(38.5%,20.3%,11.6m),P<0.05.The 1-,2-,year survival rates of the single metastasis lesion group and multiple metastasis lesion group were 47.5%,20.0% and 37.5%,12.5%,respectively,P>0.05.The 1-,2-,year survival rates of the comprehensive treatment group and supportive care group were 47.2%,16.1% and 40.0%,12.0%,respectively,P>0.05.Multivariate analysis showed that sex(P=0.026),metastasis accompanied by local recurrent diseases(P=0.020)were independent prognostic factors of NPC with distant metastasis.Conclusion: Chemotherapy and/or combined with other treatment didn’t improve the survival of metastasis nasopharyngeal carcinoma.Sex and metastasis accompanied by local recurrent diseases were independent prognostic factors of NPC with distant metastasis.