Ma Liqin, Chen Fei, Kong Xiangquan, Xu Ting, Fei Zhaodong, Fang Weining, Wang Binyi, Wu Haixia
Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, People's Republic of China.
Fujian Medical University, Fuzhou, People's Republic of China.
Cancer Manag Res. 2020 Sep 4;12:8047-8054. doi: 10.2147/CMAR.S265371. eCollection 2020.
Nasopharyngeal carcinoma (NPC) is more common among women in Southeast Asia. An important issue is whether it is safe for them to bear children after treatment and when it is safe to do so. We conducted this study to explore the relation between fertility and prognosis in child-bearing women with NPC.
Child-bearing women were defined as young women between the ages of 18 and 30. A total of 127 eligible child-bearing NPC patients were identified from December 2003 to December 2014. The patients were divided into two groups, depending on whether or not they had post-therapeutic births. The Kaplan-Meier method was used for survival analyses. The Log rank test was used to compare two survival curves and the independent significances of different prognostic factors were assessed by Cox proportional hazards regression analysis.
The 5-year overall survival (OS) and disease-free survival (DFS) in the Childbirth group were significantly higher than those in the Non-Childbirth group (100% vs 88.8%, P = 0.026 and 100% vs 77.5%, P = 0.007, respectively). In the Childbirth group, no difference was found in the 5-year DFS between different birth interval times, from 1 to 5 years after treatment. The clinical stage was identified as the risk factor of OS (HR = 101.725, 95% CI: 2.160-4790.910, P = 0.019), and consequent childbirth after treatment was associated with favorable DFS (HR = 0.148, 95% CI: 0.034-0.643, P = 0.011).
Post-therapeutic birth did not increase the mortality risk of child-bearing women with NPC. There was no significant correlation between the subsequent birth time window after treatment and the prognosis.
鼻咽癌（NPC）在东南亚女性中更为常见。一个重要问题是，她们在治疗后生育是否安全以及何时生育才安全。我们开展这项研究以探讨鼻咽癌育龄女性的生育能力与预后之间的关系。
育龄女性定义为年龄在18至30岁之间的年轻女性。2003年12月至2014年12月期间共确定了127例符合条件的育龄鼻咽癌患者。根据治疗后是否生育，将患者分为两组。采用Kaplan-Meier法进行生存分析。使用对数秩检验比较两条生存曲线，并通过Cox比例风险回归分析评估不同预后因素的独立显著性。
分娩组的5年总生存率（OS）和无病生存率（DFS）显著高于未分娩组（分别为100%对88.8%，P = 0.026；100%对77.5%，P = 0.007）。在分娩组中，治疗后1至5年不同生育间隔时间的5年DFS无差异。临床分期被确定为OS的危险因素（HR = 101.725，95%CI：2.160 - 4790.910，P = 0.019），治疗后随后的分娩与良好的DFS相关（HR = 0.148，95%CI：0.034 - 0.643，P = 0.011）。
治疗后生育并未增加鼻咽癌育龄女性的死亡风险。治疗后随后的生育时间窗与预后之间无显著相关性。
