摘要
目的:分析鼻咽癌(NPC)治疗后局部复发影响因素。方法:回顾性选取2014年3月-2017年3月深圳市宝安区人民医院156例经手术病理确诊无远处转移的NPC患者。所有患者均给予放射治疗并辅以同期化疗。所有患者治疗后随访5年,统计局部复发情况及一般资料,比较不同肿瘤分期患者局部复发率,并对NPC局部复发影响因素进行单因素及多因素分析。结果:156例NPC患者随访5年共11例局部复发,其中3例伴远处转移,1例伴颈部复发,1例同时伴远处转移及颈部复发。治疗后随访第1、2、3、4、5年局部复发占比分别为27.27%(3/11)、45.45%(5/11)、18.18%(2/11)、9.09%(1/11)、0,局部复发中位时间为27个月。Ⅰ~Ⅳ期患者局部复发率比较差异无统计学意义(P>0.05)。局部复发患者颅神经损伤、副鼻窦受侵袭、颅底骨质受侵袭占比均高于局部未复发患者(P<0.05)。本次患者颅底骨质破坏占比为27.56%(43/156),多集中于蝶窦底壁、破裂孔等,且大部分伴副鼻窦受侵、颅内受侵、颅神经损伤。颅底骨质受侵袭为NPC局部复发的危险因素(P<0.05)。结论:NPC治疗后经长期随访仍可发现局部复发,与侵犯部位相关,临床应根据不同患者临床特征行个体化治疗及长期随访,以降低局部复发风险。
Objective:To analyze the influencing factors of local recurrence in nasopharyngeal carcinoma(NPC)after treatment.Method:A total of 156 NPC patients with no distant metastasis confirmed by surgery pathology from March 2014 to March 2017 in Shenzhen Bao’an District People’s Hospital of were selected retrospectively.All patients were given the radiotherapy treatment supplemented with concurrent chemotherapy.All patients were followed up for 5 years after treatment,and the local recurrence condition and general data were counted.The local recurrence rates of patients with different tumor stages were compared,and the influencing factors of NPC local recurrence were analyzed by single factor and multi factor analysis.Result:A total of 156 NPC patients were followed up for 5 years,11 cases had local recurrence,including 3 cases with distant metastasis,1 case with cervical recurrence,and 1 case with both distant metastasis and cervical recurrence.The proportions of local recurrence were 27.27%(3/11),45.45%(5/11),18.18%(2/11),9.09%(1/11),and 0 respectively in years 1,2,3,4,5 of follow-up after treatment.The median time of local recurrence was 27 months.There was no significant difference in the local recurrence rate among stageⅠ-Ⅳpatients(P>0.05).The proportions of cranial nerve injury,invaded paranasal sinus,and invaded skull base bone in patients with local recurrence were higher than those in patients without local recurrence(P<0.05).The proportion of skull base bone destruction in this case was 27.56%(43/156),mostly concentrated in the bottom wall of the sphenoid sinus and the rupture hole,and most of them were accompanied by paranasal sinus invasion,intracranial invasion,and cranial nerve injury.Invaded skull base bone was risk factors for local recurrence of NPC(P<0.05).Conclusion:After the treatment of NPC,local recurrence can still be found through long-term follow-up,which is related to the invasion site.Individual treatment and long-term follow-up should be carried out according to the clinical characteristics of different patients to reduce the risk of local recurrence in clinic.
作者
缪文强
林晓辉
庞作良
MIAO Wenqiang;LIN Xiaohui;PANG Zuoliang(Shenzhen Bao’an District People’s Hospital,Shenzhen 518000,China;不详)
出处
《中外医学研究》
2022年第34期161-164,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
鼻咽癌
放疗
局部复发
远处转移
危险因素
Nasopharyngeal carcinoma
Radiotherapy
Local recurrence
Distant metastasis
Risk factors
