摘要
目的探讨鼻咽癌肝转移的临床特点、化疗效果及预后因素。方法采用SPSS13.0统计软件回顾性分析100例鼻咽癌肝转移化疗患者的临床资料、生存及预后因素。结果全组肝转移后中位化疗3.5程(1～14程),其中35例化疗>4程。一线化疗予PF方案和非PF方案分别为71例和29例,有效率分别为57.7%和42.9%,差异无统计学意义(P=0.137)。全组肝转移中位间期(DFS)9个月(0～119个月),肝转移后的中位生存期9个月(1～45个月),1、2、3年生存率分别为32.0%、11.0%、2.0%;化疗程数>4与≤4程患者组的中位生存期分别为14个月与7个月,差异有统计学意义(P=0.001)。单因素分析示:化疗的程数、疗效达CR及是否肝脏放疗(P值分别为0.002、0.020及0.015)影响肝转移预后;多因素分析显示DFS、初治即转移、化疗的程数、疗效达CR及肝脏放疗为影响预后的重要因素。结论鼻咽癌肝转移预后不良,对于可耐受的患者应予多程全身化疗,争取疗效达CR,部分患者可尝试辅以肝脏姑息性放疗,可显著改善预后。
Objective To investigate the clinical features ,the effect of chemotherapy and prognostic factors of nasopharyngeal carcinoma （NPC） patients with liver metastasis. Methods A total 100 eases of NPC with liver metastases and received chemotherapy were included in this study. The statistical software SPSS 13.0 was used to analyze retrospectively the clinical data, survival and prognostic factors. Results The median course of chemotherapy was 3.5 （ 1 - 14） ,in which 35 cases were more than 4 courses. The cases that used PF programs and non-PF program as the first-line chemotherapy were 71 and 29 respectively,and the effective powers were 57. 7% and 42. 9% respectively. The difference between PF programs and non-PF program was not significant （P = 0. 137 ）. In the whole group, the median disease free survival （DFS） was 9 months （0 - 119 ）, the median survival was 9 months （ 1 - 45 ） ,the 1- ,2- and 3-year survival rates were 32. 0%, 11.0% and 2. 0% respectively. The median survival durations of patients with more than 4 course chemotherapy and patients with less than 4 course chemotherapy were 14 months and 7 months respectively, which was significantly different （ P = 0. 001 ）. Single-factor analysis showed that the prognostic factors of patients with liver metastasis were the course of chemotherapy, complete remission （CR） and radiotherapy on liver metastasis （ P = 0. 002,0. 020 and 0. 015 respectively）. Multi-factor analysis showed that the important prognostic factors were DFS, metastasis before initial treatment, the course of chemotherapy, CR and radiotherapy on liver metastasis. Conclusion Prognosis of NPC with liver metastasis was poor. Multi-systemic chemotherapy should be done to strive CR if patients could tolerate. Palliative radiotherapy that may significantly improve the prognosis can also be tried on some patients.
出处
《中国癌症防治杂志》
CAS
2009年第3期238-241,共4页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
关键词
鼻咽肿瘤
肝转移
药物治疗
治疗效果
预后
Nasopharyngeal carcinoma
Liver metastasis
Chemotherapy
Therapeutic efficacy
Prognosis
