摘要
目的 探讨放疗前贫血对鼻咽癌患者预后的影响。方法 回顾性分析的829例鼻咽低分化鳞癌患者中，放疗前贫血者252例。其中轻度贫血者190例，中重度贫血者62例。卡氏评分〉80、≤80和无评价的分别占49．8％、32．4％和17．7％。按1992年福州分期中Ⅲ期和Ⅳ期占74．6％。采用6MV X线放疗，先面颈大野Dr36Gv，后改小面颈野避开脊髓加量至Dr50Gy，颈后野电子线补至BrS0Gy。原发灶和阳性淋巴结区BrT0Gy，预防区Dr150～60Gy。残存灶用后装、X刀等技术补量或观察。分析贫血对患者预后的影响以及与其他临床因素的相关性。结果 全组患者5、10年总生存率（OS）及无进展生存率（PVS）分别为75．4％、67．1％及62．9％、56．4％。放疗前贫血患者、正常患者的5年OS及PFS分别为67．8％、78．4％及55．0％、66．1％（P〈0．05）。贫血与分期及患者一般情况显著相关，与局部控制率无相关性，但与远处转移率显著相关。结论 放疗前贫血可显著降低鼻咽癌患者生存率，应纠正患者贫血以提高患者生存质量并进一步研究纠正贫血是否可提高生存率。
Objective To analyze the impact of amenia of nasopharyngeal carcinoma（NPC） patients before radiotherapy on the prognosis. Methods From 1990 to 1999, 829 NPC patients with poorly differentiated squamous cell carcinoma were analyzed retrospectively. Among them, 252 patients had had amenia, with 190 patients with mild, 62 with severe amenia . Patients who had KPS〉 80, ≤ 80 and those unseored accounted for 49.8%,32.4 % and 17.7%, respectively. 92＇ Fuzhou Staging System was used for staging（stage Ⅲ ＋ Ⅳ 74.6% ）. Radiotherapy was delivered by 6 MV X-my, facial-cervical large part was first used to give DT36 Gy, followed by small port adding DTS0 Gy to avoid damaging the spinal cord. Posterior auricular port to add Da60 Gy with β-ray may sometimes be used. Single perpendicular port may also be used. The dose at the primary lesion and metastatic lymph node were usually Dr70 Gy. Dr50 ～60 Gy was used prophylactically for the neck region which had been free from metastasis. For residual lesions, X-knife or after-loading brachytherapy was also considered. Analysis was carried on the impact factors of amenia on the prognosis and/or with other clinical factors. Results The overall 5-, 10-year survival （OS） rate and progress-free survival rate （PFS） was 75.4 %, 67.1% and 62.9 %, 56.4% ,respectively. The 5-year OS and PFS was 67.8% ,78.4% and 55.0% ,66.1% for patients with amenia and normal blood picture before radiotherapy（ P 〈 0.05）. Amenia and stage, KPS and/or metastatic rate had rela- tively importance, though related only to the local control rate. Conclusions Amenia before radiotherapy can lower the survival rate of NPC patients. We should try to improve the haemoglobin level in order to raise the survivors＇ life quality and also try to go further to see if correction of amenia may increase the survival rate.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第2期73-76,共4页
Chinese Journal of Radiation Oncology
关键词
鼻咽肿瘤/放射疗法
贫血
预后
Nasopharyngeal neoplasms/radiotherapy
Amenia
Prognosis
