摘要
目的鼻咽癌(nasopharyngeal carcinoma,NPC)发病具有地域性,在我国南部地区发病率较高。由于早期症状通常没有特异性,大部分患者就诊时已达晚期,且极易远处转移及局部复发。本研究对影响NPC进展及预后的相关因素进行总结。方法应用CNKI、Medline和PubMed期刊全文数据检索系统,以"鼻咽癌和预后"等为关键词,检索相关文献,其中英文文献2 721条,中文文献274条。纳入标准:关于鼻咽癌预后相关因素的临床和基础研究。排除标准:(1)研究设计存在缺陷或统计方法出现错误;(2)与鼻咽癌预后相关的研究结果不明确。根据纳入标准和排除标准,符合分析的文献50篇。结果越来越来的治疗因素、临床因素、生物学因素及影像学因素与NPC预后相关。随着放疗技术的发展,调强放射治疗(intensity-modulated radiotherapy,IMRT)在改善生存及降低毒副反应方面存在明显优势;在临床因素方面,虽然很多与NPC预后有关的指标被发现,但目前只有TNM分期系统被广泛接受;在生物学因素方面,血清EB病毒DNA水平被临床广泛接受;在影像学因素方面,将TNM分期与影像学尤其是18 F-FDG PET相关指标结合,可提高预后预测的准确性。如何提高EB病毒DNA的检测准确性及同质性,将成为攻克难点。此外,肿瘤放疗学的发展与医学影像学的发展密切相关,通过肿瘤影像学指标来评估NPC预后可能成为未来研究的重点之一。结论了解有关NPC进展及预后的相关因素,及早制定相应的治疗方案,能够有效的控制患者的局部复发率并提高生存率。
OBJECTIVE Nasopharyngeal carcinoma is an endemic disease,with high incidence in the southern area in our country.There is no typical symptoms,and most patients have reached advanced stage when they are firstly diagnosed.Moreover,distant metastasis(DM)and local recurrence(LR)of NPC easily happened.This study was to review relative factors about progress and prognosis of this disease.METHODS By CNKI/Medline and PubMed retrieval system,with 'nasopharyngeal carcinoma,prognosis'as the key words.There were 2 721 English and 274 Chinese literatures.Inclusion criteria:basic and clinical studies about prognostic factors of nasopharyngeal carcinoma.Exclusion criteria:(1)There was deficiency in research designs or mistakes in statistical methods.(2)Research results about prognostic factors of nasopharyngeal carcinoma were unclear.Fifty papers of literature were finally analyzed.RESULTS More treatment factors,clinical factors,biological factors and imaging factors are related to prognosis of NPC.With the development of radiotherapy technology,intensity-modulated radiotherapy(IMRT)has obvious advantages in improving survival and reducing toxic side effects.Among clinical factors,only the TNM staging system is widely accepted though many indicators related to the prognosis of NPC have been found.In terms of biological factors,the level of EB virus DNA in the serum is clinically accepted.And for imaging factors,it can improve the accuracy of prognostic prediction by associating the TNM staging with imaging indicators,especially those related to 18F-FDG PET.Furthermore,the difficulties are to improve the detection accuracy and homogeneity of EB virus DNA.In addition,the development of radiotherapy is closely related to the development of medical imaging,and to evaluate prognosis of NPC by imaging indexes may become one of the focuses of future researches.CONCLUSIONS To control LR and improve survival rate,it's necessary to investigate factors about the progress and prognosis of NPC and then make treatment protocol.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第20期1398-1402,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省自然科学基金(ZR2014YL034)
关键词
鼻咽肿瘤
预后
相关因素
综述文献
nasopharyngeal neoplasms
prognosis
relative factors
literature review
