鼻咽癌合并皮肌炎12例临床分析

Clinical Analysis of 12 Cases of Nasopharyngeal Carcinoma with Dermatomyositis

目的 探讨鼻咽癌合并皮肌炎的患者大量服用强的松对放疗疗效的影响。方法 治疗组 :12例合并皮肌炎的鼻咽癌患者接受常规放射治疗 ,同时服用较大剂量的强的松。对照组 :同期 12例单纯鼻咽癌患者接受常规放射治疗 ,分别与治疗组病例配对作为对照。 2组病例在性别、年龄、临床分期和放疗方法上无显著性差异。结果 治疗组 1、3、5年生存率分别为 91.7%、66.7%和 3 3 .3 % ;对照组分别为 10 0 .0 %、75 .0 %和 5 0 .0 % (P >0 .0 5 )。治疗组死亡 8例 ,其中死于鼻咽部癌复发 3例 ,远处癌转移 4例 ,重度皮肌炎 1例 ;对照组死亡 6例 ,其中死于鼻咽部癌复发 2例 ,远处癌转移 4例 (P >0 .0 5 )。结论 合并皮肌炎的鼻咽癌的放疗疗效与单纯鼻咽癌的放疗疗效相近 ;鼻咽癌合并皮肌炎的患者大量服用强的松未明显增加鼻咽癌复发及远处转移的发生。

Objactive To evaluate the effects of co-existing dermatomyositis(DM) and taking a lot of prednisones on the therapeutic efficiency of nasopharyngeal carcinoma(NPC).Methods Treatment group:Twelve patients of NPC with DM were treated by routine radiotherapy plus taking many prednisones simultaneously.Control group:12 patients with only NPC were treated by routine radiotherapy on corresponding period.That are similar in the sex,age,clinical stage and the methods of radiation in the twe groups.Results One,three and five year survival rate is 91.7%,66.7% and 33.3%,respectively for treatment group;100.0%, 75.0% and 50.0%,respectively for control group(P>0.05).Eight cases died from nasopharyngeal recurrence(3 cases),distant metastasis(4 cases) and severe DM(1 case),respectively in treatment group;6 cases died from nasopharyngeal recurrence(2 cases) and distant metastasis(4 cases),respectively in control group(P>0.05).Conclusion effect of NPC with DM and only NPC is similar,co-existing DM and taking a lot of prednisones will not result in asignificantly increased rate of nasopharyngeal recurrence and distant metastasis.