摘要
目的 探讨鼻咽癌放疗后首次出现继发放射性鼻窦炎时间评估患者预后的临床价值。方法 回顾2007年1月至2011年12月中国科学院大学附属肿瘤医院以及2015年1月至2018年12月杭州市第一人民医院吴山院区符合纳入排除标准共297例初治鼻咽癌患者的临床及MRI影像资料。根据MRI影像评估首次出现放疗后继发放射性鼻窦炎时间。结合鼻窦炎首发时间及其他相关临床资料,采用Kaplan-Meier法绘制生存曲线,计算累积总生存率、累积无进展生存率、累积无局部复发生存率、累积无转移生存率。应用Cox比例风险回归模型进行多因素生存分析。结果 平均随访时间(46.08±13.71)个月,累积总生存率、累积无进展生存率、累积无局部复发生存率、累积无转移生存率分别为87.2%、86.1%、86.9%、86.1%。单因素分析显示,首次发生放疗后继发放射性鼻窦炎不同时间患者的T分期、N分期、国际抗癌联盟/美国抗癌联合会分期、是否化疗比较差异均有统计学意义(均P<0.05)。多因素分析显示,放疗后1个月发生的继发放射性鼻窦炎是预测累积总生存率、累积无进展生存率、累积无局部复发生存率、累积无转移生存率的独立风险因素(均P<0.05),T_(3)~T_(4)期是影响累积总生存率的独立风险因素(P<0.05),N_(2)~N_(3b)是影响累积无局部复发生存率和累积无转移生存率的独立风险因素(均P<0.05)。结论 MRI影像学上观察到放疗后较早发生的继发放射性鼻窦炎(1个月)是预测累积总生存率、累积无进展生存率、累积无局部复发生存率、累积无转移生存率的独立风险因素,可作为临床评估鼻咽癌预后的一项经济、简便、有效的参考依据。
Objective To investigate the occurrence time of radiation-induced sinusitis after radiotherapy in predicting prognosis of patients with nasopharyngeal carcinoma(NPC).Methods The clinical and imaging data of 297 patients with newly diagnosed NPC,who underwent radiotherapy in Zhejiang Cancer Hospital from January 2007 to December 2018 and Wushan Campus of Hangzhou First People's Hospital from January 2015 to December 2018,were retrospectively analyzes.According to MRI findings,the time of first occurrence of radiation-induced sinusitis after radiotherapy was determined.The overall survival(OS),progression-free survival(PFS),local recurrence-free survival(LRFS)and metastasis-free survival(MFS)were analyzed by Kaplan-Meier method.The predicting factors of prognosis of patients were analyzed by univariate and multivariate Cox regression.Results Patients were followed for(46.08±13.71)months.The OS,LRFS,PFS,and MFS rates were 87.2%,86.1%,86.9%and 86.1%,respectively.Univariate analysis showed that the time of first occurrence of radiation-induced sinusitis after radiotherapy was significantly correlated with T stage,N stage,UICC/AJCC stage,and chemotherapy(all P<0.05).Multivariate analysis showed that the occurrence time of sinusitis at 1 month after radiotherapy was an independent predicting factor for OS,LRFS,PFS,and MFS(all P<0.05);stage T3-T4 was an independent predicting factor for OS(P<0.05);N2-N3b was an independent predicting factor for LRFS and MFS(both P<0.05).Conclusion Early occurrence of radiation-induced sinusitis after radiotherapy(1 month)is an independent predictor for OS,LRFS,PFS,and MFS in NPC patients.
作者
赵江
石磊
郗玉珍
邹莹
丁忠祥
ZHAO Jiang;SHI Lei;XI Yuzhen;ZOU Ying;DING Zhongxiang(The Fourth Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China)
出处
《浙江医学》
CAS
2023年第23期2473-2478,共6页
Zhejiang Medical Journal
基金
浙江省自然科学基金项目(LY22H180008)。
关键词
鼻咽癌
放疗
鼻窦炎
预后
预测因素
Nasopharyngeal carcinoma
Radiotherapy
Sinusitis
Prognosis
Predictive factor