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儿童和青少年鼻咽癌的预后:一项基于人群的分析。

Prognosis of nasopharyngeal carcinoma in children and adolescents: a population-based analysis.

作者信息

Shi Yi, Wu Yang, He Jiezhi, Ling Yinjie, Liu Wenyuan

机构信息

School of Medicine, Huzhou university, Huzhou, 313000, Zhejiang, China.

Department of Pediatrics, First Affiliated Hospital of Huzhou University, the First People's Hospital of Huzhou, Huzhou, 313000, China.

出版信息

BMC Pediatr. 2025 Apr 21;25(1):310. doi: 10.1186/s12887-025-05653-1.

Abstract

OBJECTIVES

The purpose of this study is to use a population-based cohort to examine the clinicopathological features and survival outcomes of nasopharyngeal cancer (NPC) in children and adolescents.

METHODS

Demographic and clinicopathological variables of pediatric patients diagnosed with NPC were extracted from the Surveillance, Epidemiology, and End Results database (2000-2018). The survival rates were calculated using Kaplan-Meier analysis. Univariate survival analysis used the log-rank test, whereas multivariate analysis used Cox proportional-hazards regression to find factors impacting overall survival (OS).

RESULTS

A total of 233 pediatric patients were analyzed, with a median age at diagnosis of 16 years (range: 7-19 years). The cancers primarily affected males (70.0%). In terms of grade, 8 (3.5%) patients were well and moderately differentiated, 31 (13.3%) patients were poorly differentiated, and 134 (57.5%) patients were undifferentiated. TNM stage and radiotherapy were significant independent predictors of overall survival. The risk of death was higher for M1 stage (hazard ratio (HR) 20.1, 95% confidence interval (CI), 8.0-50.5; P < 0.001) as compared to M0 stage. Furthermore, multivariate analysis revealed a significant survival advantage for radiotherapy treatment (HR 0.24, 95% CI, 0.09-0.68; P = 0.007).

CONCLUSION

NPC in children is rare and should be studied independently. This study found that TNM stage and radiotherapy were the most significant survival predictors, emphasizing the importance of these parameters in the prediction and treatment of pediatric NPC.

摘要

目的

本研究旨在利用基于人群的队列研究,探讨儿童和青少年鼻咽癌(NPC)的临床病理特征及生存结局。

方法

从监测、流行病学和最终结果数据库(2000 - 2018年)中提取诊断为NPC的儿科患者的人口统计学和临床病理变量。采用Kaplan-Meier分析计算生存率。单因素生存分析使用对数秩检验,多因素分析使用Cox比例风险回归来寻找影响总生存(OS)的因素。

结果

共分析了233例儿科患者,诊断时的中位年龄为16岁(范围:7 - 19岁)。癌症主要影响男性(70.0%)。在分级方面,8例(3.5%)患者为高分化和中分化,31例(13.3%)患者为低分化,134例(57.5%)患者为未分化。TNM分期和放疗是总生存的显著独立预测因素。与M0期相比,M1期的死亡风险更高(风险比(HR)20.1,95%置信区间(CI),8.0 - 50.5;P < 0.001)。此外,多因素分析显示放疗治疗具有显著的生存优势(HR 0.24,95% CI,0.09 - 0.68;P = 0.007)。

结论

儿童鼻咽癌罕见,应独立研究。本研究发现TNM分期和放疗是最重要的生存预测因素,强调了这些参数在儿童鼻咽癌预测和治疗中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f36/12010594/4ceb6b821434/12887_2025_5653_Fig1_HTML.jpg

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