无远处转移鼻咽癌患者治疗后局部复发的回顾性研究

Risk Factors of Local Recurrence after Treatment in Patients with Nasopharyngeal Carcinoma without Distant Metastasis

[目的]分析鼻咽癌患者临床特征及放疗后鼻咽局部复发的现状及影响因素,为鼻咽癌的防治提供科学依据。[方法]共纳入820例经病理确诊无远处转移鼻咽癌患者,对局部局部进行单因素和多因素分析。[结果]820例患者5年局部复发87例,占10.61%,10年复发复发129例,占15.73%。多因素Logistic回归分析显示放疗联合化疗（OR=2.298,95%CI：1.359-3.886,P=0.012）、颅神经损伤（OR=2.042,95%CI：1.377-3.028,P=0.024）和颅底骨质受侵（OR=1.732,95%CI：1.097-2.734,P=0.005）是鼻咽癌局部复发的独立影响因素。[结论]影响鼻咽癌复发的因素较多,根据不同患者的临床特征对个体进行个体化的治疗和长期的随访观察是降低鼻咽癌复发的有效手段。

[Objective] To analyze the risk factors of local recurrence after treatment in patients with nasopharyngeal carcinoma（NPC） without distant metastasis. [Methods] A total of 820 patients with NPC treated between January 2012 and December 2016 were enrolled in this study.The risk factors of local recurrence were analyzed by univariate and multivariate analyses. [Results] Among 820 patients,local recurrence occurred within 5 years in 87 cases,accounting for10.61%;and with 10 years in 129 cases,accounting for 15.73%. Multivariate logistic regression analysis showed that radiotherapy combined with chemotherapy（OR=2.298,95%CI：1.359～3.886,P=0.012）,cranial nerve injury（OR=2.042,95%CI：1.377～3.028,P=0.024） and skull base invasion（OR=1.732,95%CI：1.097～2.734,P=0.005） were the independent risk factors for local recurrence of NPC. [Conclusion] Based on the risk factors,individualized management and long-term followup are important to reduce the local recurrence of nasopharyngeal carcinoma.