103例鼻咽癌放射治疗后的预后因素分析

Prognostic Factors of 103 Patients with Nasopharygeal Carcinoma Treated with Radiotherapy

目的分析影响鼻咽癌放射治疗后的远期预后因素。方法选择2000年1月～2002年12月鼻咽癌患者109例，均采用^60Co常规分割放射治疗，照射剂量68～80Gy／7～8周，分析8项可能对鼻咽癌预后产生影响的因素，利用统计软件进行单因素及Cox回归模型多因素分析。结果总5年生存率为62．5％。在单因素分析中，临床分期、N分期、T分期、颅神经损害、颅底骨破坏、血红蛋白水平影响鼻咽癌的预后（P〈0．01）；而多因素分析中N分期、T分期、颅神经损害、颅底骨破坏、血红蛋白水平为影响鼻咽癌的独立预后因素。结论N分期、T分期、颅神经损害、颅底骨破坏、血红蛋白水平是影响鼻咽癌放射治疗疗效的主要因素，对此类病例需进行综合治疗，以减少肿瘤的复发及转移，提高患者的生存率。

Objective To analyze the prognostic factors of nasopharyngeal carcinoma treated with radiotherapy. Methods 103 cases of nasopharyngeal carcinoma from January 2000 to December 2002 were selected and treated with radiotherapy to a total dose of 68 -80 Gy with ^60co .f - ray in 7 -8 weeks Univariate analysis of prognostic factors was performed using Iogrank test and multivariate analysis using Cox model. Results The. overall 5 - year survival rate was 62.5%,Univariate analysis suggested that the clinical stage, and N stage, T stage, cranial nerve invasion, skull base destruction, the peripheral blood hemoglobin concentration were significant factors for prognosis （P 〈 0.05）. Multiple factors analysis suggested that T and N stage, cranial nerve invasion, skull base destruction, the peripheral blood hemoglobin concentration were independent prognosis factor. Conclusions The prognosis of patients with cranial nerve palsy and/or skull base invasion and/or bigger cervical tumor and/or the poor peripheral blood hemoglobin concentration is poor. Comprehensive treatment may reduce relapse and metastasis and improve the patient＇s survival.