江苏省启东市鼻咽癌生存率长期趋势分析

An analysis of long-term survival trends for nasopharyngeal carcinoma in Qidong,Jiangsu

目的分析1972—2016年启东市人群鼻咽癌发病生存情况。方法1060例鼻咽癌登记患者的生存情况随访截至2021年12月31日。采用SURV 3.01软件计算观察生存率(OSR)和相对生存率(RSR),Hakulinen氏似然比检验法进行统计检验。采用国际癌症生存标准年龄结构计算年龄标化相对生存率(ARSR)。Joinpoint 4.7.0.0分析生存率年度平均变化百分比(AAPC)。将1972—2016年按5年为1个时期,分成9个时期进行分组处理。结果鼻咽癌患者1、5、10年OSR分别为63.02%、34.70%和24.72%,1、5、10年RSR分别为64.44%、38.98%和31.64%。9个时期的RSR上升趋势有统计学意义(χ^(2)=112.16,P<0.001)。全组鼻咽癌患者中,男性患者1、5、10年RSR分别为62.66%、35.89%和27.94%,女性患者1、5、10年RSR分别为68.30%、45.67%和39.68%,男、女性RSR差异无统计学意义(χ^(2)=14.16,P=0.656)。25~34岁、35~44岁、45~54岁、55~64岁、65~74岁及75+岁各年龄组患者的5年RSR分别为52.83%、40.92%、42.64%、38.65%、27.23%和28.88%,各年龄组之间RSR差异有统计学意义(χ^(2)=42.33,P=0.003)。鼻咽癌患者1、5、10年ARSR分别为63.64%、37.33%和27.10%,其中男性分别为61.82%、35.60%和25.20%,女性分别为68.36%、43.12%和32.93%。时间趋势显示,5年ARSR的AAPC为2.71%(t=7.47,P<0.001),其中男性5年ARSR的AAPC为2.63%(t=4.98,P=0.002),女性5年ARSR的AAPC为2.71%(t=6.08,P=0.001),男女合计、男性、女性5年ARSR的上升趋势均有统计学意义。25~34岁、35~44岁、45~54岁、55~64岁、65~74岁及75+岁年龄组5-RSR的AAPC分别为2.16%(t=4.28,P=0.004)、3.38%(t=5.06,P=0.001)、1.99%(t=2.82,P=0.026)、2.82%(t=3.39,P=0.012)、2.20%(t=2.82,P=0.026)和-0.91%(t=-0.42,P=0.689),除75+岁年龄组的5年RSR呈下降趋势外,其余年龄组的上升趋势均有统计学意义。结论启东市1972—2016年间的鼻咽癌总体生存率呈上升趋势,需要引进规范的多学科综合治疗模式,进一步改善治疗效果、提高生存率。

Objective To analyze the survival of nasopharyngeal carcinoma patients in Qidong from 1972 to 2016,and provide a basis for the prognosis evaluation and prevention for nasopharyngeal carcinoma patients.Methods A total of 1060 registered nasopharyngeal carcinoma patients were followed up for survival outcomes until December 31,2021.Observed survival rate(OSR)and relative survival rate(RSR)was calculated by Hakulinen method in SURV3.01 software,and Hakulinen′s likelihood ratio test was used for statistical difference comparison.Age-standardized relative survival rate(ARSR)was calculated according to the International Cancer Survival Standard(ICSS).Joinpoint 4.7.0.0 software was used to conduct the annual average percentage change(AAPC)in nasopharyngeal carcinoma survival rate.The period from 1972 to 2016 is divided into 9 periods for grouping processing according to 5 years.Results The OSR of nasopharyngeal carcinoma at 1,5,10 years were 63.02%,34.70%and 24.72%,the RSR at 1,5,10 years were 64.44%,38.98%and 31.64%,respectively.The uptrends of RSR in the nine periods were statistically significant(χ^(2)=112.16,P<0.001).The 1,5,10 years RSR for males were 62.66%,35.89%and 27.94%,while the 1,5,10 years RSR for females were 68.30%,45.67%and 39.68%,respectively.There was no statistically significant difference in RSR between males and females(χ^(2)=14.16,P=0.656).The 5-year RSR for the age groups of 25-34,35-44,45-54,55-64,65-74,and over 75 years old were 52.83%,40.92%,42.64%,38.65%,27.23%and 28.88%,respectively.There was a statistically significant difference in RSR among different age groups(χ^(2)=42.33,P=0.003).Moreover,the ARSR of nasopharyngeal carcinoma at 1,5,10 years were 63.64%,37.33%and 27.10%,for males were 61.82%,35.60%and 25.20%,for females were 68.36%,43.12%and 32.93%.Period trend showed that the AAPC of 5-ARSR was 2.71%(t=7.47,P<0.001)from 1972 to 2016 in Qidong.The AAPC of 5-ARSR in males and females were 2.63%(t=4.98,P=0.002)and 2.71%(t=6.08,P=0.001).There was statistically significant increase in 5-year ARSR among both genders.Furthermore,the AAPC of 5-year RSR among 25-34,35-44,45-54,55-64,65-74 and 75+years old were 2.16%(t=4.28,P=0.004),3.38%(t=5.06,P=0.001),1.99%(t=2.82,P=0.026),2.82%(t=3.39,P=0.012),2.20%(t=2.82,P=0.026)and-0.91%(t=-0.42,P=0.689),respectively.Except for the 75+years old age group,the other age groups were significantly upward trend.Conclusions The overall survival rate of nasopharyngeal carcinoma in Qidong from 1972 to 2016 has shown an upward trend.It is necessary to introduce standardized multi-disciplinary treatment mode to improve treatment effect and survival rate.