| 王婷婷,黄生富,郭文杰.99例Ⅳa期鼻咽癌的预后分析[J].肿瘤学杂志,2013,19(9):713-717. |
| 99例Ⅳa期鼻咽癌的预后分析 |
| Analysis of Prognosis in 99 Cases with Nasopharyngeal Carcinoma Stage Ⅳa |
| 投稿时间：2013-03-20 |
| DOI：10.11735/j.issn.1671-170X.2013.09.B011 |
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| 中文关键词: 鼻咽肿瘤 临床分期 调强放疗 预后 |
| 英文关键词:nasopharyngeal neoplasms clinical stage intensity modulated radiation therapy prognosis |
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| 中文摘要: |
| 摘 要：［目的］ 分析Ⅳa期鼻咽癌患者的预后及影响预后的因素。［方法］ 将99例Ⅳa期鼻咽癌纳入分析。Kaplan-Meier法计算生存数据，并对Ⅳa期鼻咽癌的预后相关因素行单因素和多因素分析。［结果］ 全组病例3年局部控制率、无远处转移生存率、无进展生存率、疾病相关总生存率分别为87.3%、75.8%、69.3%及77.9%，远处转移是治疗失败主要原因。单因素分析提示N分期较晚患者（N2~3）其生存显著低于N分期较早者（P<0.05）。多因素分析提示N分期较晚影响Ⅳa期病例远处转移发生，但无统计学差异（N0~1 vs. N2~3，HR=0.396，95%CI：0.144~1.086，P=0.072）。N2~3的Ⅳa期患者其无远处转移生存和无进展生存率显著低于N0~1的Ⅳa期患者（P=0.023，P=0.011），局部控制率则无显著差异（P=0.432）。［结论］ 中国鼻咽癌2008分期中Ⅳa期病例预后具有很大的不一致性，主要由颈部淋巴结分期的早晚决定。 |
| 英文摘要: |
| Abstract:［Purpose］ To investigate the prognosis and influencing factors in patients with nasopharyngeal carcinoma(NPC) stage Ⅳa. ［Methods］ Ninety-nine patients with NPC stage Ⅳa were enrolled. Survival data were calculated with Kaplan-Meier method. Univariate and multivariate analyses were performed to investigate the risk factors of prognosis for NPC stage Ⅳa.［Results］ The local control(LC)，distant metastasis-free survival(DMFS)，progression-free survival(PFS) and disease-specific overall survival(OS) at 3 years were 87.3%，75.8%，69.3% and 77.9% respectively. Distant metastasis was the main failure factor. Univariate analysis showed that patients with advanced nodal staging(N2～3) had a significantly poor DMFS compared with early nodal staging(P＜0.05). Multivariate analysis showed that advanced nodal staging(N2~3) influenced the incidence of distant metastasis，but without significant difference(N0～1 vs N2～3，HR=0.396，95%CI:0.144～1.086，P=0.072). DMFS and PFS in patients with N2～3 stage Ⅳa were significantly worse than those in patients with N0～1 stage Ⅳa（P=0.023，P=0.011）. No significant difference was observed in LC between the two groups(P=0.432). ［Conclusion］ Prognosis of patients with NPC stage Ⅳa is greatly inconsistent in China 2008 NPC staging system，which is dependent on nodal staging. |
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