鼻咽癌常规放疗中肿瘤退缩速度对预后的影响分析

Impact Analysis of Conventional Radiotherapy in Nasopharyngeal Tumor Regression Rate on the Prognosis

目的探究鼻咽癌患者接受放疗后肿瘤退缩速度对于其预后的影响状况。方法选自本院2009年至2011年收治的鼻咽癌患者肿瘤快速退缩、缓慢退缩以及残留患者各100例，患者的原发肿瘤和转移淋巴结受体外照射的处方剂量在66-72Gy，颈部受预防剂量在50～52Gy。肿瘤在照射剂量〈50Gy时全退缩为快速退缩，在50-70Gy的为缓慢退缩，超过70Gy的定义为残留。对患者应用Cox回归模型进行分析，使用Kaplan—Meier方法进行生存分析。结果三组患者的5年生存率分别为64．0％、72．0％和49．0％无病生存率分别为60．O％、72．0％以及29．0％。对患者进行多因素分析，认为对其预后有直接影响的因素有：N分期、T分期以及肿瘤退缩速度。结论鼻咽癌患者接受根治性放疗治疗过程中，自身的5年生存率、无病生存率等受到肿瘤退缩速度影响，其中以缓慢退缩的预后效果最佳。

Objective To explore the effect of patients with nasopharyngeal carcinomatumor regression speed for its prognosis after radiotherapy. Methods The patients with nasopharyngeal carcinoma tumor in our hospital from 2005-2008 years were selected from the rapid retreat, slow retreat and residue of the 100 cases of patients, patients with primary tumor and metastatic lymph nodes by in vitro irradiation dose between 65-70Gy, the neck by the prophylactic dose between 50-55Gy. Completely shrink faster than 50Gy for the rapid withdrawal, withdrawal speed between 50-70Gy sl0w retreat, defined over 70Gy for residual. For patients with Cox regression model, using the Kaplan-Meier method was used for survival analysis. Results 5 year survival rate in patients of the three groups were 64 %, 72 % and 49 %; disease free survival rates were 60 %, 72 % and 29 %. Multivariate analysis was performed on patients, factors that are directly linked to the prognosis： N staging, T staging and tumor regression speed. Conclusion Nasopharyngeal carcinoma patients received radical radiotherapy treatment process, the 5 year survival rate, disease free survival rate by tumor regression speed effect, the prognosis effect to slow retreat of the best.