鼻咽癌放疗后放射性脑病的影响因素回归分析

Regression Analysis of Influencing Factors of Radiation Encephalopathy of Nasopharyngeal Carcinoma after Radiotherapy

目的探讨影响鼻咽癌放疗后发生放射性脑病(REP)的相关因素。方法收集102例鼻咽癌患者的临床资料。采用Logsitic回归模型分析鼻咽癌放疗后发生REP的影响因素。结果首程放疗和再程放疗患者放疗后REP的潜伏期差异无统计学意义(P>0.05)。单因素分析结果显示年龄、病理类型、临床分期、放疗方法、放疗总剂量、颈部淋巴结肿大、颈/脑动脉硬化、疗程和复发是影响REP发生的相关因素(P均<0.05)。多因素分析结果显示年龄、临床分期、放疗方法、放疗总剂量、颈/脑动脉硬化和疗程是影响REP发生的独立危险因素(P均<0.05)。结论鼻咽癌患者放射治疗中应充分考虑患者的自身因素,制定合理的放疗方案,做好放疗后的监测、随访工作,降低REP的发生率。

Objective To investigate the related factors of radiation eucephalopathy （REP） of nasopharyngeal carcinoma after radiotherapy. Methods Clinical data of 102 patients with nasopharyngeal carcinoma were collected, and they were divided into REP group and non REP group according to the imaging results. Used Logsitie regression model to analyze the influencing factors of REP after radiotherapy in nasopharyngeal carcinoma. Results The difference of latency of REP in the 2 groups was statistically significant （ P 〉 0.05 ）. Univariate analysis showed that age, pathological type, clinical stage, radiotherapy, total dose and radiotherapy of cervical lymph node enlargement, carotid/cerebral arteriosclerosis, treatment and recurrence were related factors influencing the occurrence of REP （ P 〈 0.05 ）. Multivariate analysis showed that age, clinical stage, radiotherapy, total dose of radiotherapy, carotid/cerebral artel7 sclerosis and treatment were independent risk factors for REP （ P 〈 0.05 ）. Conclusion In the radiotherapy for nasopharyngeal carcinoma patients ,we should fully consider the patient＇s own factors, formulate a reasonable ra- diotherapy plan,do a good job in monitoring and follow-up, and reduce the incidence of REP.