摘要
目的分析同步推量调强放疗对老年鼻咽癌患者预后及免疫功能的影响。方法回顾性分析2010年2月至2012年4月于本院行同步推量调强放疗的100例老年鼻咽癌患者的临床资料。比较治疗后即刻患者免疫功能的变化,治疗后第1、2、3年的生存率以及影响患者生存率的相关因素,并观察不良反应发生情况。结果治疗后即刻,CD4/CD8和CD19水平较治疗前均明显下降(P<0.05);治疗前和治疗后即刻,CD56水平比较无显著差异(P>0.05)。治疗后3例患者复发,复发时间分别为治疗后的第9、12、22个月;治疗后第1、2、3年,无局部复发生存率分别为99%(99/100)、97%(97/100)、97%(97/100);11例患者发生远处转移,其中,骨转移4例,肝转移3例,纵隔转移1例,多发转移3例。治疗后第1、2、3年无远处转移生存率分别为91%(91/100)、90%(90/100)、85%(85/100);9例患者发生鼻咽肿瘤相关性死亡,其中2例患者均于治疗后6个月因鼻咽部大出血死亡,7例患者因肿瘤远处转移死亡,治疗后第1、2、3年总生存率分别为95%(95/100)、92%(92/100)、85%(85/100)。本研究未发生治疗相关性死亡。T分期与临床分期是总生存率的影响因素(P<0.05),N分期是无远处转移生存率的影响因素(P<0.05),临床分期是无局部复发生存率的影响因素(P<0.05)。T分期、临床分期与鼻咽癌的预后显著相关,是影响患者总生存率的独立因素。所有患者治疗后均发生了不同程度的皮肤反应、口腔黏膜反应及白细胞减少症,经对症治疗后均得到了有效缓解,且对疗效无影响。结论同步推量调强放疗治疗老年鼻咽癌,能够获得良好的总生存率,T分期和临床分期与鼻咽癌预后相关,但该方法可抑制患者的免疫功能。
Objective To analyze the effect of simultaneous integrated boost-intensity modulated radiotherapy on the prognosis and immune function of elderly patients with nasopharyngeal carcinoma. Method 100 patients with nasopharyngeal carcinoma from February 2010 to April 2012 in our hospital were selected as the research objects. Compared the changes of immune function of patients after treatment, the survival rate of the first 3 years after treatment and the related factors affecting the survival rate of the patients, and observed the adverse reactions. Result After treatment, CD4/CD8 and CD19 levels were significantly decreased （P 〈 0.05）; before and after treatment, the level of CD56 had no significant difference （P 〉 0.05）. 3 patients relapsed after treatment, recurrence time respectively after treatment of 9, 12, 22 months; 1, 2, 3 years after treatment, no local recurrence rates were 99% （99/100）, 97% （97/100）, 97% （97/100）; 11 patients with distant metastasis, among them, 4 cases of bone metastasis, 3 cases of liver metastasis, mediastinal shift in 1 case, multiple transfer in 3 cases, 1, 2, 3 years after treatment without distant metastasis survival rates were 91% （91/100）, 90% （90/100）, 85% （85/100）; 9 cases of patients with nasopharyngeal cancer related death, among them, 2 cases were in 6 months after treatment for nasopharyngeal hemorrhage died, 7 patients died of tumor distant metastasis, 3 years preceding the oerall survival rates were 95% （95/100）, 92% （92/100）, 85% （85/100）. No treatment-related deaths appeared in this study. T stage and clinical stage were the influence factors of overall survival （P 〈 0.05）, N stage was the influencing factor of the survival rate of no distant metastases （P 〈 0.05）, the clinical stage was the influencing factor of the recurrence free, survival rate （P 〈 0.05）. T stage, clinical stage and the prognosis of nasopharyngeal carcinoma were significantly related, they were the independent factors influencing the
出处
《中国医学前沿杂志（电子版）》
2016年第10期121-125,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
同步推量调强放疗
鼻咽癌
免疫功能
老年
Simultaneous integrated boost-intensity modulated radiotherapy
Nasopharyngeal carcinoma
Immune fimction
Elderly
