摘要
背景与目的:年龄对鼻咽癌患者治疗效果及生存影响的研究在国内外少有报道,本文通过回顾性研究分析老年鼻咽癌患者的临床特征。方法:对2000年1月1日至2002年5月1日中山大学肿瘤防治中心收治的754例鼻咽癌初诊且无远处转移的患者,按年龄<60岁和≥60岁区分成年组(647例)与老年组(107例),比较两组间临床特征、治疗方法与合并其它疾病的差异,并通过COX回归分析年龄因素对生存的影响程度与方式。结果:鼻咽癌年龄分布呈单峰模式。肿瘤特征、放疗剂量和放疗时间在老年组与成年组间无差别,老年组接受化疗的比例较小(254/647vs.29/107,P=0.016),合并其它疾病的比例较多(40/107)。与成年组相比,老年患者的3年肿瘤相关生存率明显偏低(82.95%vs.72.90%,P=0.010)。COX回归分析显示,年龄与Q92福州N分期是独立的预后因素,年龄的生存优势比为1.604(95%CI:0.929～2.768),P=0.026。结论:老年鼻咽癌患者的3年生存率较成年患者差,可能与化疗风险大、难以足量足疗程实施有关,但排除化疗影响后,年龄本身仍是不良预后因素。
BACKGROUND ＆ OBJECTIVE. The influence of age on treatment outcome and survival of nasopharyngeal carcinoma （NPC） patients has seldom been reported. This study was to explore the clinical characters of aged NPC patients. METHODS： A total of 754 patients with histopathologically proven NPC from Jan. 1, 2000 to May 1, 2002 were divided to adult group （〈60 years old, 647 patients） and aged group （≥60 years old, 107 patients）. The difference of disease characters, treatment patterns, and other complications between these two groups were analyzed. The influence of age on survival was analyzed with COX regression model. RESULTS. There was no difference between the two groups in disease characters, radiation dose, and interval time. However, the proportion of the patients received chemotherapy was significantly larger in adult group than in aged group （254/647 vs. 29/107, P=0.016）, while the occurrence of complications was more frequent in aged group than in adult group （40/107 vs. 19/647, P〈 0.001 ）. The 3-year tumor-specific survival rate was significantly lower in aged group than in adult group （72.90% vs. 82.95%, P=0.010）. COX multivariable analysis showed that age and ＇92 Fuzhou N stage were independent prognostic factors, and the odds ratio （OR） of age was 1.604 （95% CI. 0.929-2.768） （P=0.026）. CONCLUSIONS. Aged NPC patients have worse 3-year survival than adult patients, which may be related to the high risk of chemotherapy and less possibility to tolerate enough doses and cycles. But age itself is still a poor prognostic factor when excluding the influence of chemotherapy.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第6期740-743,共4页
Chinese Journal of Cancer
关键词
鼻咽肿瘤
老年人
临床特征
生存分析
预后因素
Nasopharyngeal neoplasm；Age
Clinical characters
Survival analysis
Prognostic factor
