Zheng Wei, Xu Yuan-Ji, Qiu Su-Fang, Zong Jing-Feng, Huang Ling-Ling, Huang Chao-Bin, Lin Shao-Jun, Pan Jian-Ji
Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, China E-mail :
Asian Pac J Cancer Prev. 2015;16(10):4393-9. doi: 10.7314/apjcp.2015.16.10.4393.
To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC).
A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC.
The 1-, 3- and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3- and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor.
Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.
探讨局部区域晚期鼻咽癌(LANPC)患者复发/转移的独立预后因素。
选取福建省肿瘤医院604例经病理组织学初诊为LANPC的患者,分析临床病理类型、治疗方案及临床分期与LANPC复发/转移的关系。
LANPC患者1年、3年和5年的局部区域复发率分别为2.0%、9.5%和12.9%,平均复发时间为78个月。单因素分析结果表明临床分期对LANPC患者的复发时间有一定影响。然而,COX回归模型显示年龄、性别和临床分期不是影响复发的独立预后因素。LANPC患者1年、3年和5年的转移率分别为6.6%、17.5%和18.8%,平均转移时间为73个月。单因素分析结果表明年龄、N分期、临床分期、淋巴结位置、咽后淋巴结及淋巴结包膜外侵犯对LANPC患者的转移时间有一定影响。此外,进一步的COX回归分析结果提示T分期、诱导化疗方案及淋巴结包膜外侵犯是影响LANPC患者转移的独立预后因素,其中T分期和淋巴结包膜外侵犯是危险因素,诱导化疗方案是保护因素。
诱导化疗对LANPC患者初始治疗有益,应用诱导化疗后转移率大幅降低。