邱慧芝,王琳婧,莫浩元.905例鼻咽癌远期疗效及失败模式的探讨[J].肿瘤学杂志,2018,24(6):555-561.
905例鼻咽癌远期疗效及失败模式的探讨
Long-term Outcomes and Treatment Failure of 905 Nasopharyngeal Carcinoma Patients Treated with Radiotherapy
投稿时间:2017-09-15  
DOI:10.11735/j.issn.1671-170X.2018.06.B006
中文关键词:  鼻咽肿瘤  治疗失败  预后
英文关键词:nasopharyngeal carcinoma  patterns of treatment failure  prognosis
基金项目:
作者单位
邱慧芝 广州医科大学附属肿瘤医院 
王琳婧 广州医科大学附属肿瘤医院 
莫浩元 中山大学肿瘤防治中心 
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中文摘要:
      摘 要:[目的] 分析905例鼻咽癌患者的远期生存情况及治疗失败模式并探讨其预后因素。[方法] 回顾性分析2004年10月至2005年12月中山大学肿瘤防治中心收治的905例经病理证实的初治无转移鼻咽癌患者的临床资料。采用 Kaplan-Meier 法进行生存分析,Cox 回归模型进行多因素预后分析。[结果] 全组中位随访时间为118.6个月(1.6~152.4个月),5年及10年总生存率(OS)、无局部区域复发率(LRFS)、无远处转移生存率(DMFS)、无病生存率(DFS)分别为77%、91%、86%、79%和67%、88%、85%、75%。211例(23.3%)患者治疗失败,出现远处转移、局部复发、区域复发的患者分别为126例、82例、14例。远处转移(13.9%)最常见,其次是鼻咽局部复发(9.1%),颈部淋巴结复发(1.5%)较少。多因素分析显示T、N分期是影响总生存、无远处转移生存及无病生存的独立因素,年龄是影响总生存的独立因素。[结论] 早期鼻咽癌治疗效果良好,但局部晚期患者治疗效果较差,远处转移是鼻咽癌治疗失败的首要原因。
英文摘要:
      Abstract:[Objective] To analyze the long-term outcomes and treatment failure patterns and to investigate the prognostic factors of 905 nasopharyngeal carcinoma patients.[Methods] From October 2004 to December 2005,905 patients with histology-proven newly diagnosed non-metastatic nasopharyngeal carcinoma treated in Sun Yat-sen university cancer center were reviewed. Survival analysis was performed with Kaplan-Meier method. Multivariate prognostic factors were analyzed by Cox regression model.[Results] During a median follow up of 118.6 months(range 1.6~152.4m). The 5,10-year OS,LRFS,DMFS and DFS were 77%,91%,86%,79% and 67%,88%,85%,75% respectively. Of 905 patients,211 patients developed failure after treatment. And 126,82,14 had developed distant metastasis,primary recurrence and regional nodal recurrence. Distant metastasis(13.9%) was the major failure after treatment,followed by primary recurrence(9.1%),the rate of regional nodal recurrence(1.5%) was comparatively low. Multivariate analysis showed that T stage and N stage were independent prognostic factors for OS,DMFS and DFS;age was an independent prognostic factor for OS.[Conclusions] Satisfactory survival outcomes are obtained in early-stage nasopharyngeal carcinoma patients,but patients with advanced stage had unfavorable survivals,distant failure is the most common failure pattern after treatment for NPC.
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