Background and Objective:Nasopharyngeal carcinoma (NPC) is known for its propensity for distant metastases.Lung metastasis is one of the most important causes of death for patients with NPC.Solitary metastatic lung tu...Background and Objective:Nasopharyngeal carcinoma (NPC) is known for its propensity for distant metastases.Lung metastasis is one of the most important causes of death for patients with NPC.Solitary metastatic lung tumor from NPC is a distinctive group associated with a better survival.This study was to find a more effective treatment modality and prognostic factors for the group.Methods:Clinical data of 105 cases of solitary metastatic lung tumor from NPC were retrospectively analyzed.Survival rate was calculated by the Kaplan-Meier method.The difference of survival between the patients treated by different modalities was evaluated by the log-rank test.The Cox univariate and multivariate analyses of gender, age, pathologic type, stage, adjuvant chemotherapy, evaluation of treatment for NPC, disease-free interval, size of metastatic tumor, pulmonary hilar and/or mediastinal lymph node metastasis, treatment modalities, recurrent distant metastases and/or relapse of NPC were conducted.Results:The local control rate was 53.8% in chemotherapy group, 88.0% in radiotherapy +/-chemotherapy group, and 96.4% in operation +/-chemotherapy group (P<0.01).The most promising progression-free survival (PFS) and overall survival (OS) were obtained with operation +/-chemotherapy and followed by radiotherapy +/-chemotherapy.Both of them showed much better efficacy than chemotherapy (P<0.001).The Cox multivariate analysis showed that recurrent distant metastases and/or relapse of NPC affected the survival (OR=2.087, 95% CI=1.277-3.410, P=0.003).The T stage of NPC, size of metastatic tumor, hilar and/or mediastinal lymph node metastasis, and the treatment modality were independent prognostic factors.Conclusions:Operation +/-chemotherapy and radiotherapy +/-chemotherapy are better treatment of solitary metastatic lung tumor from NPC, which could improve the local control and prolong the PFS and OS.Chemotherapy is recommended for patients with higher T stage of NPC, size of metastatic tumor ≥3 cm, pulmonary hilar and/or mediastinal lymph node metastasis.展开更多
目的:探讨骨代谢生化指标血清Ⅰ型胶原交联氨基末端肽(N-telopeptide of typeⅠcollagen,NTx)和骨涎酸蛋白(bone sialoprotein,BSP)的检测对肺癌和乳腺癌骨转移的临床意义。方法:选择2006年1月至2006年7月长海医院肿瘤科经病理确诊的肺...目的:探讨骨代谢生化指标血清Ⅰ型胶原交联氨基末端肽(N-telopeptide of typeⅠcollagen,NTx)和骨涎酸蛋白(bone sialoprotein,BSP)的检测对肺癌和乳腺癌骨转移的临床意义。方法:选择2006年1月至2006年7月长海医院肿瘤科经病理确诊的肺癌或乳腺癌患者105例,分为两组,其中骨转移组50例,无骨转移组55例。应用ELISA法检测患者血清NTx和BSP浓度。结果:骨转移组患者血清NTx和BSP水平均明显高于无骨转移组(P<0.01)。NTx诊断骨转移的灵敏度和特异度分别为90.0%和67.3%,BSP诊断骨转移的灵敏度和特异度分别为84.0%和70.9%。临床发生骨相关事件(skeletal related event,SRE)的骨转移患者,血清NTx水平明显高于未发生SRE的骨转移患者(P<0.05)。在6～13个月随访期内,21例患者确诊了新发骨转移;采用Cox比例风险回归模型分析,血清NTx浓度升高提示骨转移发生的相对危险度为1.127;乳腺癌患者血清BSP增高是唯一预测骨转移的危险因素(P<0.05),其相对危险度为1.058。随访期共有33例患者死亡;无论肺癌还是乳腺癌,血清BSP增高患者的累积生存率均明显低于血清BSP正常组(P<0.05)。结论:血清NTx和BSP是诊断肺癌和乳腺癌骨转移的重要参考指标,其水平的增高是预测骨转移发生的高危因素;BSP可能是肺癌和乳腺癌患者独立预后指标。展开更多
文摘Background and Objective:Nasopharyngeal carcinoma (NPC) is known for its propensity for distant metastases.Lung metastasis is one of the most important causes of death for patients with NPC.Solitary metastatic lung tumor from NPC is a distinctive group associated with a better survival.This study was to find a more effective treatment modality and prognostic factors for the group.Methods:Clinical data of 105 cases of solitary metastatic lung tumor from NPC were retrospectively analyzed.Survival rate was calculated by the Kaplan-Meier method.The difference of survival between the patients treated by different modalities was evaluated by the log-rank test.The Cox univariate and multivariate analyses of gender, age, pathologic type, stage, adjuvant chemotherapy, evaluation of treatment for NPC, disease-free interval, size of metastatic tumor, pulmonary hilar and/or mediastinal lymph node metastasis, treatment modalities, recurrent distant metastases and/or relapse of NPC were conducted.Results:The local control rate was 53.8% in chemotherapy group, 88.0% in radiotherapy +/-chemotherapy group, and 96.4% in operation +/-chemotherapy group (P<0.01).The most promising progression-free survival (PFS) and overall survival (OS) were obtained with operation +/-chemotherapy and followed by radiotherapy +/-chemotherapy.Both of them showed much better efficacy than chemotherapy (P<0.001).The Cox multivariate analysis showed that recurrent distant metastases and/or relapse of NPC affected the survival (OR=2.087, 95% CI=1.277-3.410, P=0.003).The T stage of NPC, size of metastatic tumor, hilar and/or mediastinal lymph node metastasis, and the treatment modality were independent prognostic factors.Conclusions:Operation +/-chemotherapy and radiotherapy +/-chemotherapy are better treatment of solitary metastatic lung tumor from NPC, which could improve the local control and prolong the PFS and OS.Chemotherapy is recommended for patients with higher T stage of NPC, size of metastatic tumor ≥3 cm, pulmonary hilar and/or mediastinal lymph node metastasis.
文摘目的:探讨骨代谢生化指标血清Ⅰ型胶原交联氨基末端肽(N-telopeptide of typeⅠcollagen,NTx)和骨涎酸蛋白(bone sialoprotein,BSP)的检测对肺癌和乳腺癌骨转移的临床意义。方法:选择2006年1月至2006年7月长海医院肿瘤科经病理确诊的肺癌或乳腺癌患者105例,分为两组,其中骨转移组50例,无骨转移组55例。应用ELISA法检测患者血清NTx和BSP浓度。结果:骨转移组患者血清NTx和BSP水平均明显高于无骨转移组(P<0.01)。NTx诊断骨转移的灵敏度和特异度分别为90.0%和67.3%,BSP诊断骨转移的灵敏度和特异度分别为84.0%和70.9%。临床发生骨相关事件(skeletal related event,SRE)的骨转移患者,血清NTx水平明显高于未发生SRE的骨转移患者(P<0.05)。在6～13个月随访期内,21例患者确诊了新发骨转移;采用Cox比例风险回归模型分析,血清NTx浓度升高提示骨转移发生的相对危险度为1.127;乳腺癌患者血清BSP增高是唯一预测骨转移的危险因素(P<0.05),其相对危险度为1.058。随访期共有33例患者死亡;无论肺癌还是乳腺癌,血清BSP增高患者的累积生存率均明显低于血清BSP正常组(P<0.05)。结论:血清NTx和BSP是诊断肺癌和乳腺癌骨转移的重要参考指标,其水平的增高是预测骨转移发生的高危因素;BSP可能是肺癌和乳腺癌患者独立预后指标。
