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目的:探讨初诊远处转移鼻咽癌预后的影响因素,为临床选择治疗方案提供依据。方法:收集1997-1-2003-12在我院确诊时或在治疗期间发生远处转移的209例鼻咽癌患者临床资料。采用SPSS13.0软件,用Kaplan-Meier法计算生存率,用Log-rank检验各组生存率。采用Cox逐步回归模型进行多因素分析。结果:全组病例1、2和3年生存率分别为61.0%、32.0%和16.0%,中位生存时间为15.47(0.83～96.63)个月。其中27例未治疗患者中位生存期9.23(2.80～44.23)个月,1、2和3年生存率分别为37.0%、14.0%和5.0%。182例接受治疗患者的中位生存期为17.6(0.83～96.63)个月,1、2和3年生存率分别为65.0%、35.0%和18.0%(χ2=11.642,P=0.001)。单因素分析显示,性别(P=0.038)、治疗方式(P=0.000)和化疗周期数(P=0.000)是初诊远处转移鼻咽癌预后的影响因素。多因素分析显示,治疗方式(P=0.004)和化疗周期(P=0.001)是影响初诊远处转移鼻咽癌预后的独立因素。结论:治疗方式和化疗周期是影响初诊远处转移鼻咽癌预后的独立因素。
Objective: To explore the prognostic factors of distant metastasis of nasopharyngeal carcinoma in newly diagnosed cases and to provide basis for clinical choice of treatment. Methods: The clinical data of 209 patients with nasopharyngeal carcinoma who were distantly metastasized from 1997-1-2003-12 in our hospital or during the treatment were collected. Using SPSS13.0 software, Kaplan-Meier method was used to calculate the survival rate, and Log-rank test was used to evaluate the survival rate of each group. Cox regression model was used for multivariate analysis. Results: The 1, 2 and 3 year survival rates were 61.0%, 32.0% and 16.0% respectively in the whole group, and the median survival time was 15.47 (0.83 ~ 96.63) months. The median survival time of 27 untreated patients was 9.23 (2.80 ~ 44.23) months, and the 1, 2, and 3-year survival rates were 37.0%, 14.0% and 5.0%, respectively. The median survival of 182 patients treated was 17.6 (0.83-96.63) months, and the 1, 2, and 3-year survival rates were 65.0%, 35.0%, and 18.0%, respectively (χ2 = 11.642, P = 0.001). Univariate analysis showed that gender (P = 0.038), treatment (P = 0.000) and number of chemotherapy cycles (P = 0.000) were the influencing factors for the prognosis of newly diagnosed nasopharyngeal distant metastasis. Multivariate analysis showed that treatment modalities (P = 0.004) and chemotherapy cycles (P = 0.001) were independent prognostic factors for newly diagnosed distant metastatic NPC. Conclusion: The treatment mode and chemotherapy cycle are the independent factors affecting the prognosis of nasopharyngeal carcinoma in newly diagnosed distant metastasis.