初治鼻咽癌患者的治疗分析:附130例报告

目的:探讨初治鼻咽癌患者的治疗方法、疗效及晚期损伤。方法:选择2006年1月—2011年1月收治的130例首程放疗鼻咽癌患者,其中122例患者接受化疗,生存预后的单因素分析采用Kaplan-Meier法,并行Log-rank检验,采用Cox比例风险模型进行多因素分析,采用美国肿瘤放射治疗协作组织(Radiation Therapy Oncology Group,RTOG)/欧洲癌症治疗研究组织(European Organization for Research on Treatment of Cancer,EORTC)标准评价晚期损伤。结果:初治鼻咽癌患者的中位随访时间为56个月,5年总生存率、局部区域无复发生存率、无瘤生存率分别为64.8%、74.3%、58.2%。单因素分析结果表明,同期化疗是影响鼻咽癌患者5年总生存率、局部区域无复发生存率和无瘤生存率的有利因素。多因素分析结果表明,同期化疗是鼻咽癌患者局部区域无复发生存率和无瘤生存率的独立影响因素。130例患者均有不同程度口干,听力明显下降15例,放射性脑病2例,张口困难5例。结论:同期化疗有助于提高初治鼻咽癌患者的放疗后局部区域无复发生存率和无瘤生存率。

Analysis of Initial Treatment in Patients with Nasopharyngeal Carcinoma: a Report of 130 Cases

Objective：To investigate the treatment method,therapeutic efficacy and the late toxicities of initial treatment in patients with nasopharyngeal carcinoma（NPC）.Methods：A total of 130 patients with NPC who underwent radiotherapy as initial treatment from Jan 2006 to Jan 2011 were enrolled,122 of whom received chemotherapy.Kaplan-Meier method and Log-rank test were used in univariate analysis on survival and prognostic factors.Cox proportional hazards model was used in multivariate analysis on survival and prognostic factors.The late toxicities were graded according to the criteria of Radiation Therapy Oncology Group（RTOG）/European Organization for Research on Treatment of Cancer（EORTC）.Results：The median follow-up time was 56 months in patients with NPC who underwent initial treatment.The 5-year overall survival rate（OS）,the local regional recurrent-free survival rate（LRRFS）,and the disease-free survival rate（DFS） of the whole cohort were 64.8％,74.3％ and 58.2％ respectively.Univariate analysis revealed that concomitant chemotherapy was beneficial influence factor for OS,LRRFS and DFS.In the multivariate analysis,it was proved that concomitant chemotherapy remained to be the independent factor for LRRFS and DFS.Different degree of xerostomia was found in all patients.Among them,15 patients with hearing impairment,2 patients with radiation encephalopathy and 5 patients with inability to open the mouth were found.Conclusions：The concomitant chemotherapy is conducive to increasing LRRFS and DFS of patients with NPC after radiotherapy.