摘要
目的：探讨鼻咽癌咽旁间隙侵犯程度与预后的关系。方法：２１９例初诊鼻咽癌经ＣＴ扫描后将咽旁间隙侵犯程度分为：０级：无侵犯；Ⅰ级：轻度侵犯；Ⅱ级：重度侵犯。应用ＫａｐｌａｎＭｅｉｅｒ方法和Ｃｏｘ模型对放疗后５年的局控率、无远处转移生存率、无瘤生存率及影响预后因素进行分析和评价。结果：咽旁０、Ⅰ、Ⅱ级侵犯的５年无瘤生存率分别为６９９１％、６０７２％、３２１３％，后者明显低于前两者（Ｐ≤０．０００３），而前两者比较则无差异（Ｐ＝０．４７３６）；Ⅱ级侵犯的５年鼻咽局控率（６８７％）、颈部局控率（７６４％）和无远处转移生存率（５８５％）也明显低于０级（分别为８９９％、９５３％和８８０％）和Ⅰ级（分别为８３７％、９５８％和８１５％），统计学上有显著差异。多因素Ｃｏｘ模型显示Ｎ分期、咽旁侵犯程度和副鼻窦（包括海绵窦）侵犯是影响预后的显著性因素。结论：咽旁间隙重度（Ⅱ级）侵犯是鼻咽癌预后较差的重要影响因素之一。
Objective:To evaluate the prognostic effect of paranasopharyngeal space extension of nasopharyngeal carcinoma.Methods:Two hundreds and nineteen patients with newly diagnosed nasopharyngeal carcinoma receiving CT scan before radiotherapy were analyzed.Tumor extension into the paranasopharyngeal space was graded as:0 (no extension), 1(mild extension) and 2 (extensive extension). Relapse free, distant metastasis free (DMFa) and disease free survival (DFS) in 5 years after the treatment were estimated using the KaplanMeier method.Cox model was also performed to adjust prognostic factors. Results:The 5year DFS rates for Grade 0,1,2 paranasopharyngeal extension were 69.91%,60.72%,32.13%,respectively.The main difference was between Grade 2 and Grade 0 or 1 extension(P≤0.0003),but no difference was noticed between Grade 0 and 1 extension(P=0.4736).Grade 2 extension had a lower 5year nasopharynx control rate (68.7%),neck control rate (76.4%)and DMFS rate (58.5%) as compared with Grade 0 (89.9%,95.3% and 88.0%,respectively)or Grade 1(83.7%,95.8% and 81.5%,respectively),the differences were statistically significant between the former and the latter.Multivariate Cox model analysis showed that N classification,paranasopharyngeal extension and paranasal sinuses (including cavernous sinus) involvement were significant factors in predicting DFS. Conclusions:Extensive paranasopharyngeal extension (Grade 2) was an important prognostic factor with poorer treatment outcome.It was reasonable that it was classified as T3 classification in 92's nasopharyngeal carcinoma clinical classification.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
1998年第4期286-289,共4页
Chinese Journal of Cancer
关键词
鼻咽肿瘤
放射疗法
咽旁间隙侵犯
预后
Nasopharyngeal Neoplasms/radiotherapy Paranasopharyngeal extension Prognostic
