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[目的]探讨儿童鼻咽癌放射治疗后的生存率和后遗症及影响预后的因素。[方法]对49例7～14岁的儿童鼻咽癌患者采用单纯放射治疗或放射治疗加化疗。用SPSS13.0统计软件包的Kaplan-Meier法计算生存率,用Log-rank法对两组病人的生存率进行比较,应用COX模型进行多因素分析。[结果]全组病人的1、3、5年生存率分别为85.7%、62.5%、53.2%。单因素分析显示,性别(P=0.028)、年龄(P=0.035)、治疗前影像学检查方法(P=0.043)和近期疗效(P=0.000)是影响儿童鼻咽癌预后的因素。多因素分析显示,近期疗效(P=0.028)是影响儿童鼻咽癌预后的因素。后遗症方面:目前生存的7例女性患者均出现月经减少或月经不规则;5例患者出现Ⅰ~Ⅱ度记忆力下降等。[结论]近期疗效是影响儿童鼻咽癌预后的独立因素,儿童鼻咽癌放射治疗的后遗症应引起重视。
[Objective] To investigate the survival rate and sequelae of children with nasopharyngeal carcinoma after radiotherapy and the factors that affect prognosis. [Method] 49 cases of children with nasopharyngeal carcinoma of 7-14 years old were treated with radiotherapy alone or radiotherapy plus chemotherapy. Kaplan-Meier method was used to calculate the survival rate with SPSS 13.0 statistical package. The survival rates of the two groups were compared by Log-rank method, and multivariate analysis was performed by COX model. [Results] The 1, 3, 5-year survival rates of all patients were 85.7%, 62.5% and 53.2% respectively. Univariate analysis showed that gender (P = 0.028), age (P = 0.035), pre-treatment imaging (P = 0.043) and short-term efficacy (P = 0.000) were the factors affecting the prognosis of children with NPC. Multivariate analysis showed that the short-term efficacy (P = 0.028) was a factor affecting the prognosis of children with NPC. Sequelae: The current 7-year-old female patients have experienced menstrual reduction or irregular menstruation; 5 patients with grade Ⅰ ~ Ⅱ memory loss and so on. [Conclusion] The recent curative effect is an independent factor affecting the prognosis of children with nasopharyngeal carcinoma. The sequelae of radiotherapy for children with nasopharyngeal carcinoma should be paid more attention.