颈部淋巴结阴性鼻咽癌患者放疗疗效的影响因素分析

Influencing Factors of Efficacy of Radiotherapy for Nasopharyngeal Carcinoma Patients with Negative Cervical Lymph Node

目的探讨影响N0期鼻咽癌患者放射治疗预后的影响因素。方法回顾性分析150例N0期鼻咽癌患者的临床资料。应用^(60)Coγ射线或直线加速器6MV X射线治疗,常规分割,2 Gy/次,5次/周,连续放疗。采用KaplanMeier方法进行生存分析,Log-rank法检验差异性,多因素分析采用COX风险比例模型。结果至随访结束,共有死亡患者38例(25.3%),5年总生存率为74.7%,T1、T2、T3、T4期生存率分别为93.3%、85.7%、70.0%和48.6%,各分期5年生存率比较差异显著(χ~2=21.993,P=0.000)。单因素分析结果显示:性别、T分期、鼻咽癌肿瘤残留、颈动脉鞘区受侵、颅底骨质破坏、贫血是影响N0期鼻咽癌预后的影响因素。多因素分析结果显示:T分期是N0期鼻咽癌预后的唯一独立影响因素。结论 N0期鼻咽癌采用放射治疗可获得良好的预后,T分期是鼻咽癌预后的唯一独立影响因素。

Objective To investigate the prognostic factors of patients with stage NO nasopharyngeal carcinoma treated by radiotherapy. Methods Retrospective analysis of clinical data of 150 patients with stage NO nasopharyngeal carcinoma were conducted. All of them treated with 60Coγ or linear accelerator 6MV X-ray, conventional segmentation, 2 Gy/times, 5 times/ week, continuous radiotherapy. Survival analysis was conducted by Kaplan-Meier method, the Log-rank method was used to test the difference,and the multi factor analysis was conducted by COX risk ratio model. Results Until the end of follow-up,38 cases died（25.3% ） and 5-year overall survival rate was 74.7%. T1, T2, T3, T4 survival rates were 93.3% , 85.7% ,70.0% and 48.6% ,respectively,there was significant difference between（ X^2 = 21. 993 ,P = 0.000） them. Single factor analysis showed that gender,T stage, tumor residual, carotid sheath invasion, skull base bone destruction and anemia were the influencing factors of prognosis of NO stage nasopharyngeal carcinoma patients. Multivariate analysis showed that T stage was the only independent prog- nostic factor of stage NO nasopharyngeal carcinoma. Conclusion NO stage nasopharyngeal carcinoma treated with radiotherapy can achieve good prognosis and T stage is the only independent prognostic factor for nasopharyngeal carcinoma.