摘要
目的 探讨影响鼻腔恶性肿瘤患者预后的因素。方法 回顾性分析 16 3例鼻腔恶性肿瘤患者的临床和随访资料。生存分析采用Kaplan Meier法 ,组间比较采用Logrank检验。多因素分析采用Cox模型。结果 全组患者的 5年生存率为 5 8.2 % ,其中鳞癌为 5 5 .8% ,腺癌为 4 4 .0 % ,未分化癌为 5 9.7% ,腺样囊性癌为 76 .3% ,黏液表皮样癌为 71.4 % ,横纹肌肉瘤为 2 5 .0 % ,恶性黑色素瘤为2 6 .7% ,嗅神经母细胞瘤为 5 0 .0 % ,组间比较差异无统计学意义。有颈部淋巴结转移者 5年生存率为5 3.5 % ,无颈部淋巴结转移者为 5 8.9% ,差异无统计学意义。出现筛窦、上颌窦和蝶窦侵犯的患者预后较差。治疗结束后 ,原发肿瘤全消者 5年生存率为 73.8% ,有肿瘤残留者为 4 1.6 % ,肿瘤不变者为34.3% ,三者间差异有统计学意义 (P <0 .0 1)。Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者 5年生存率分别为 78.3%、5 6 .4 %、5 4 .2 %和 35 .9% ,各期间比较差异有统计学意义 (P <0 .0 5 )。单纯放疗者的 5年生存率为5 6 .9% ,单纯手术治疗者为 5 6 .6 % ,单纯化疗者为 2 5 .0 % ,综合治疗者 (手术加放疗、放疗加化疗、手术加化疗、放疗加手术加化疗 )为 6 1.8% ,各组间差异无统计学意义。 85例患者死于肿瘤 ,其中 4 9例(5 7.6 % )死于肿瘤未控与复发。?
Objective To analyze the factors affecting prognosis of patients with nasal carcinoma. Methods 163 patients treated from 1985 to 1998 were analyzed. The survival analysis was performed by Kaplan Meier estimate and the comparison between groups by Log rank test. Multivariate analysis was carried out by Cox proportional hazard model. Results The overall 5 year survival rate was 58.2%. The 5 year survival rate was 55.8% in squamous cell carcinoma, 44.0% in adenocarcinoma, 59.7% in undifferentiated carcinoma, 76.3% in adenoid cystic carcinoma, 71.4% in mucoepidermoid carcinoma, 25.0% in rhabdomyosarcoma, 26.7% in malignant melanoma, 50.0% in neuroblastoma (P>0.05). Patients with cervical metastasis gave a 5 year survival of 53.5% while those without gave 58.9% (P>0.05). Patients with involvement of sphenoidal sinus or maxillary sinus gave the worse survival. The 5 year survival rate was 73.8% in patients whose cancer completely disappeared after treatment. It was 41.6% in patients whose cancer incompletely disappeared, and 34.3% in patients whose cancer remained refractory (P<0.01). The 5 year survival was 78.3% in stage Ⅰdisease, 56.4% in stage Ⅱ disease, 54.2% in stage Ⅲ and 35.9% in stage Ⅳ( P<0.05). The 5 year survival rate of patients who were treated with radiotheraphy only was 56.9%. That of patients who were treated with surgery only was 56.6%.That with chemotherapy only was 25.0% whereas that of patients treated with combination treatment was 61.8%(P> 0.05 ). So far, 85 patients have died up to writing this report, 57.6%(49 patients) of recurrence or uncontroled. Conclusion Clinical stage, immediate therapeutic response and involvement of sphenoidal or maxillary sinus; but not the pathologic type, the presence of cervical metastasis nor the method of treament,are the factors affecting the prognosis of patients with nasal carcinoma. Recurrence and uncontrolled disease are the cause of death.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2005年第2期117-121,共5页
Chinese Journal of Oncology
基金
广州市科技局资助项目 (2 0 0 2Z3 E0 0 11)
