鼻咽癌根治性放疗后发生远处转移患者的预后及其影响因素分析

Analysis on prognosis and influencing factors of distant metastasis occurrence after radical radiotherapy in patients with nasopharyngeal carcinoma

目的研究鼻咽癌根治性放疗后发生远处转移患者的预后并分析其影响因素。方法随访150例鼻咽癌根治性放疗后发生远处转移的患者,采集其临床数据进行预后分析及影响因素分析。结果随访患者的中位生存时间为13.50个月,1年生存率49.8%,2年生存率31.0%,3年生存率19.3%。Cox模型单因素分析结果表明初诊N分期、初诊是否化疗、完成放疗到发生远处转移的时间间隔、转移部位、发生远处转移后化疗与否及化疗期数、是否进行姑息性放疗为预后相关影响因素(均P<0.05),其中初诊N分期、转移部位、发生远处转移后化疗与否、完成放疗到发生远处转移的时间间隔、是否进行姑息性放疗为预后的独立影响因素(均P<0.05)。结论鼻咽癌根治性放疗后发生远处转移患者预后的独立影响因素有初诊N分期、转移部位、发生远处转移后化疗与否、完成放疗到发生远处转移的时间间隔、是否进行姑息性放疗。

Objective To study the prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy and to analyze its influencing factors.Methods One hundred and fifty patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy were followed up.Their clinical data were collected to conduct the prognosis analysis and influencing factors analysis.Results The median survival time in the follow up cases was 13.50 months,the one-year survival rate was 49.8%,two-year survival rate was 31.0% and three-year survival rate was 19.3%.The Cox model single factors analysis results showed that the N stage in initial diagnosis,whether conducting chemotherapy in initial diagnosis,time interval from radiotherapy finish to distant metastasis occurrence,metastasis site,chemotherapy after distant metastasis,chemotherapy cycles and palliative radiotherapy were the prognosis related influencing factors（P0.05）,in which the N stage,metastatic site,chemotherapy after distant metastasis,time interval from radiotherapy finish to distant metastasis occurrence and palliative radiotherapy were the independent influencing factors of prognosis（P0.05）.Conclusion The independent factors of prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy are the N stage at initial diagnosis,metastatic site,whether having chemotherapy after distant metastasis,time interval from radiotherapy finish to distant metastasis occurrence and whether conducting the palliative radiotherapy.