鼻腔副鼻窦恶性肿瘤术后放疗临床分析

Postoperative radiotherapy for nasal and paranasal sinus carcinoma

目的探讨影响鼻腔副鼻窦恶性肿瘤术后放疗效果与预后的因素。方法95例鼻腔副鼻窦恶性肿瘤接受术后放疗,生存率计算采用Kap lan-M e ier法,生存率差异检验采用Logrank法,多因素分析采用Cox模型。结果1,3,5,10年总生存率分别为84.2%、50.5%、44.2%和20.0%。单因素分析显示,性别、年龄、手术方法和肿瘤剂量与生存率无相关性;而临床分期、病理类型与生存率相关。多因素分析显示,临床分期、病理类型是影响预后的独立因素。视力障碍、听力障碍、口干是治疗的主要毒副作用。结论临床分期、病理类型是影响鼻腔副鼻窦恶性肿瘤术后放疗效果和预后的重要因素,术后放疗能够提高鼻腔副鼻窦恶性肿瘤的疗效。

Objective To evaluate the factors influencing the efficacy of postoperative radiotherapy in treatment of nasal and paranasal sinus carcinoma and the prognosis. Methods Ninty-five patients receiving postoperative radiotherapy for nasal and paranasal sinus carcinoma were reviewed retrospectively. KaplanMeier method was used to analyze the survival rate and Log-rank test was used to compare the difference in survival rates between groups. Multivariate analysis was performed using Cox proportional hazard model. Results The overall 1-,3-,5- and 10-year survival rates were 84.2% ,50.5% ,44. 2% and 20.0% , respectively. Univariate analysis showed that sex, age, operative modality and tumor dose were not associated with survival rate,while histological and clinical stages were associated with survival rate. Multivariate analysis in- dicated that histological and clinical stages were independent prognostic factors. The follow-up results indicated that visual disturbance, xerostomia and dysaudia were the major side effects. Conclusions Histological and clinical stages are the independent prognostic factors for nasal and paranasal sinus carcinoma. Postoperative radiotherapy improves efficacy in the treatment of nasal and paranasal sinus carcinoma.