摘要
目的:分析鼻咽癌放疗后诱发的恶性肿瘤的发病率、临床特点,探讨影响潜伏期及预后的因素。方法:1964年2月至2003年12月在中山大学肿瘤防治中心接受根治性放疗的初治鼻咽癌患者39118例,回顾性分析其中出现诱发肿瘤的198例患者临床资料。结果:鼻咽癌放疗后诱发的恶性肿瘤发病率为0.5%,中位潜伏期108(36～360)个月。口腔是诱发肿瘤最常见的发病部位,共107例(54.0%)。病理类型中鳞癌最多,共137例(69.2%),其次为纤维肉瘤21例(10.6%)及骨肉瘤12例(6.1%)。潜伏期与鼻咽癌患者放疗时年龄、放疗程式、鼻咽癌总剂量及化疗有关。多因素分析显示性别、诱发肿瘤复发是影响诱发肿瘤患者预后的独立因素。结论:鼻咽癌患者放疗后诱发的恶性肿瘤以口腔肿瘤最多见。鼻咽癌放疗患者应尽量减少口腔组织的受量,以减少诱发肿瘤的发生。
Objective： To investigate the incidence rate and clinical characteristics of radiation-induced malignancies in nasopharyngeal carcinoma patients and to analyze factors that impact latency and prognosis. Methods： Data from a total of 39,118 patients with nasopharyngeal eareinoma who underwent radical radiotherapy as the initial treatment between February 1964 and December 2003 were collected. Characteristics and outcome of 198 patients with carcinoma induced alter radiotherapy were analyzed retrospectively. Results： The incidence rate of radiation-induced malignant tumor in these patients was 0.5%. The median latency was 108（36-360） months. The oral cavity was the most frequently involved site （N=107, 54.0%）. Squamnus cell carcinoma was the most frequently observed pathology type （N=137, 69.2%）, followed by fibrosarcoma （N=21, 10.6%） and osteosareoma （N=12, 6.1%）. Latency was related to radiation pattern, radiation dose, chemotherapy, and the patients＇age at whieh they received radiotherapy. Multivariate analysis showed that the risk factors that independently influenced the overall survival were gender and relapse of induced carcinoma. Conclusion： The malignant tumor most frequently induced by radiotherapy for nasopharyngeal carcinoma is carcinoma in the oral cavity. Reducing the radiation dose to the oral cavity will help decrease the incidence of radiation-induced malignancies after radiotherapy for nasopharyngeal carcinoma.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第6期313-316,共4页
Chinese Journal of Clinical Oncology
关键词
鼻咽肿瘤
放射治疗
放疗诱发
恶性肿瘤
Nasopharyngeal carcinoma
Radiotherapy
Radiation-induced carcinoma
Malignancy
