放疗在颈部淋巴结阴性鼻咽癌患者中的应用效果与疗效影响因素分析

Analysis of Influencing Factors of Application Effect and Curative Effect of Radiotherapy in Patients with Cervical Lymph Node Negative Nasopharyngeal Carcinoma

目的探讨放疗在颈部淋巴结阴性鼻咽癌患者中的应用效果与疗效影响因素。方法回顾性分析2012年4月—2014年9月在该院就诊的颈部淋巴结阴性鼻咽癌患者200例的临床资料,均行放疗治疗,随访3年后统计其应用效果,并分析影响疗效的单因素及Logistic多因素。结果经3年随访,200例患者存活率为77.50%;死亡患者中女性、T4期、贫血、颅底骨质破坏、颈动脉鞘区受侵及鼻咽肿瘤残留所占比例均高于存活者,差异有统计学意义(Z/χ~2=20.191、5.645、5.740、7.738、5.320、7.542,P<0.05);经Logistic分析,贫血、颅底骨质破坏、颈动脉鞘区受侵、鼻咽肿瘤残留及T分期均为影响疗效的危险因素(OR=2.279、3.159、2.198、2.667、3.018,P=0.018、0.007、0.023、0.007、0.000)。结论放疗治疗颈部淋巴结节阴性鼻咽癌患者可在一定程度上延长生存时间,且贫血、颅底骨质破坏、颈动脉鞘区受侵、鼻咽肿瘤残留及T分期为影响疗效的危险因素。

Objective To study the influencing factors of application effect and curative effect of radiotherapy in patients with cervical lymph node negative nasopharyngeal carcinoma. Methods 200 cases of patients with cervical lymph node negative nasopharyngeal carcinoma diagnosed in our hospital from April 2012 to September 2014 were selected and treated with radiotherapy, and the application effect was counted after three years, and the single factor and Logistic multi-factor of curative effect were analyzed and affected. Results After three-year follow-up, the survival rate of 200 cases of patients was 77.50%, and the ratios of female, T4 stage, anemia, skull base bone destruction, carotid sheath area invasion and nasopharyngeal tumor residual of death patients were higher than the survival patients, and the differences were statistically significant,（ Z/χ~2=20.191, 5.645, 5.740, 7.738, 5.320, 7.542, P〈0.05）, and the Logistic analysis showed that the anemia, skull base bone destruction, carotid artery sheath invasion, nasopharyngeal tumor residual and T staging were the risk factors of curative effect（ OR=2.279, 3.159, 2.198, 2.667, 3.018, P=0.018, 0.007, 0.023, 0.007, 0.000）. Conclusion The radiotherapy of patients with cervical lymph node negative nasopharyngeal carcinoma can prolong the survival quality to a certain degree,and the anemia, skull base bone destruction, carotid artery sheath invasion, nasopharyngeal tumor residual and T staging can be the risk factors of influencing the curative effect.