138例鼻咽未分化癌与低分化鳞癌的回顾性分析

Retrospective analysis of 138 cases undifferented and low-differented nasopharyngeal carcinomas

目的:回顾性分析鼻咽未分化癌与鼻咽低分化鳞癌的疗效及预后因素。方法:应用Kaplan-Meier法及Cox分析69例鼻咽未分化癌与随机抽取同期收治的69例鼻咽低分化鳞癌的临床资料。结果:鼻咽未分化癌与低分化鳞癌皆以中晚期病例为主,Ⅲ、Ⅳ期病例皆占75.4%,治疗后,两者的生存率差异无统计学意义(P=0.9535)。未分化癌中Ⅲ、Ⅳ期病例,放化疗组5年生存率51.5%,而单纯放疗组的5年生存率为36.8%,放化疗组与单纯放疗组的生存率差异有统计学意义(P=0.0486)。而对低分化鳞癌,两者的生存率差异无统计学意义(P=0.413)。结论:鼻咽未分化癌与鼻咽低分化鳞癌在TNM分期及治疗后生存率上无显著性差异。对Ⅲ、Ⅳ期未分化癌,联合放化疗较单纯放疗可提高其生存时间。Cox分析显示生存时间仅与TNM分期有关。

Objective：To retrospectively analyze the therapeutic efficacy and prognosis of undiffbrentiated and low-differentiated nasopharyngeal carcinomas. Methods：Retrospective analysis were done upon 69 undifferentiated NPC cases and 69 low-differentiatcd NPC cases which were selected by random from 1995 to 2001 according to Kaplan-Meicr and Cox regression analysis. Results：Advanced cases of stage Ⅲ, Ⅳ remained major in undifferentiated NPC and low-differentiated NPC, accounting for 75.4% respectively. Their survival rates had no significant difference （ P = 0. 953 5 ）. In the cases of undiffeerentiated NPC at stage Ⅲ, Ⅳ ,5 years survival rate was 51.5% treated by radiotherapy combined with chemotherapy ,meanwhile it was 36. 8% by radiotherapy alone. Their survival rates had significant difference （ P = 0. 048 6）. But to low-differentiated NPC, there＇s no significant difference （ P = 0. 413 ）. Conclusion： In clinical stage and survival time, there＇s no significant difference between undifferentiated NPC and low-differentiated NPC after treatment. Radiotherapy combined with chemotherapy can improve survival time compared with radiotherapy alone. Cox regression analysis showed that only TNM stage was the most significant prognosis factor.