鼻咽癌咽旁间隙受侵对远处转移影响的研究

Prognostic significance of parapharyngeal space involvement on distant metastasis in nasopharyngeal carcinoma

目的:分析鼻咽癌咽旁间隙受侵对患者治疗后远处转移的影响。方法:1999年全年住院治疗的原发鼻咽癌患者405例,对其中接受放射治疗并完成根治剂量、治疗前及治疗中无远处转移证据且随访资料完整者381例进行回顾性分析。结果:咽旁间隙侵犯与未侵犯者5年累积无远处转移生存率分别为73·57%和86·19%,P=0·0042;茎突前间隙侵犯与未侵犯者分别为73·03%和86·80%,P=0·0017;茎突后间隙侵犯与未侵犯者分别为66·63%和86·23%,P=0·0000。无远处转移生存率相关因素为颈淋巴结转移、茎突后间隙受侵和临床分期。结论:咽旁间隙受侵尤其是茎突后间隙受侵与远处转移密切相关,茎突后间隙受侵时转移淋巴结的分期与远处转移无关。

OBJECTIVE： To analyse the influence on distant metastasis of parapharyngeal space involvement in nasopharyngeal carcinoma（NPC）. METHODS： Four humered and five cases in-patients on primary NPC were definited by CT scan and histopathology at our cancer center in 1999. Among these, 381 patients with radical radiotherapy and complete follow up informations were analysed retrospectively, all of which had no evidence of distant metastasis before and during the treatment. RESULTS： The 5-year distant metastasis free survival rates, with and without parapharyngeal space involvement, prestyloid space involvement and poststyloid space involvement, were 73. 57% and 86.19%, 73.03% and 86. 80%, 66. 63% and 86. 23%, respectively, and P were 0. 004 2, 0. 001 7 and 0. 000 0, respectively. The distant metastasis free survival rate was negatively affected by the presence of lymph node metastasis, poststyloid space involvement and clinical stage by multivariate analyses. CONCLUSIONS： The distant metastasis rate is affected by parapharyngeal space involvement, especially the poststyolid space involvement. Given poststyloid space involvement, the stage of the metastatic lymph node has nothing to do with distant metastasis rate.