CAJ | 학술논문

目的应用MRI评价鼻咽癌椎前间隙受侵对放、化疗预后的影响.方法回顾分析2005-2007年间经病理证实的初治及无远处转移鼻咽癌患者333例临床资料.所有病例行鼻咽部和颈部MRI扫描并经二维、三维放疗或加化疗.Kaplan-Meier法计算生存率并Logrank法检验,Cox法多因素预后分析.结果随访率95.2％.鼻咽癌椎前间隙受侵139例(41.7％),椎前间隙受侵组较未受侵组T分期、临床分期明显增加(x2=90.41、54.03,P=0.000、0.000).鼻咽癌椎前间隙受侵组与未侵犯组5年总生存率(OS)、无远处转移生存率(DMFS)及无局部区域复发生存率(LRFS)分别为58.8％与77.5％ (x2=11.95,P=0.000),77.8％与85.0％(x2=2.56,P=0.110)及88.3％与91.8％(x2 =1.51,P=0.220).经N分期调整后两组5年OS差异仍有统计学意义(x2=9.93,P=0.002). 多因素分析显示椎前间隙受侵不是影响鼻咽癌OS、DMFS、LRFS的预后因素(x2=0.43、0.08、0.00,P=0.512、0.783、0.971).结论鼻咽癌椎前间隙受侵发生率较高且比未受侵者的OS低,但椎前间隙受侵不是影响鼻咽癌患者预后的因素.
목적 응용MRI평개비인암추전간극수침대방、화료예후적영향.방법 회고분석2005-2007년간경병리증실적초치급무원처전이비인암환자333례림상자료.소유병례행비인부화경부MRI소묘병경이유、삼유방료혹가화료.Kaplan-Meier법계산생존솔병Logrank법검험,Cox법다인소예후분석.결과 수방솔95.2％.비인암추전간극수침139례(41.7％),추전간극수침조교미수침조T분기、림상분기명현증가(x2=90.41、54.03,P=0.000、0.000).비인암추전간극수침조여미침범조5년총생존솔(OS)、무원처전이생존솔(DMFS)급무국부구역복발생존솔(LRFS)분별위58.8％여77.5％ (x2=11.95,P=0.000),77.8％여85.0％(x2=2.56,P=0.110)급88.3％여91.8％(x2 =1.51,P=0.220).경N분기조정후량조5년OS차이잉유통계학의의(x2=9.93,P=0.002). 다인소분석현시추전간극수침불시영향비인암OS、DMFS、LRFS적예후인소(x2=0.43、0.08、0.00,P=0.512、0.783、0.971).결론 비인암추전간극수침발생솔교고차비미수침자적OS저,단추전간극수침불시영향비인암환자예후적인소.
Objective To evaluate the prognostic impact of MRI-detected prevertebral space involvement in nasopharyngeal carcinoma (NPC) treated with radiotherapy and chemotherapy.Methods A retrospective analysis was performed on the clinical data of 333 patients who had newly diagnosed biopsyproven NPC without distant metastasis from 2005 to 2007.All patients underwent MRI scans of the nasopharynx and neck and were treated with two-and three-dimensional radiotherapy without or without chemotherapy.The Kaplan-Meier method was used to calculate overall survival (OS),distant metastasis-free survival (DMFS),and locoregional relapse-free survival (LRFS),and the log-rank test was used for survival difference analysis;the Cox proportional hazards regression analysis was used to assess the prognostic value of prevertebral space involvement.Results The follow-up rate was 95.2％.Prevertebral space involvement was seen in 139(41.7％) of these patients.The patients with prevertebral space involvement had significantly higher T stage and clinical stage than those without prevertebral space involvement (x2 =90.41,P =0.000;x2 =54.03,P =0.000).The 5-year OS,DMFS,and LRFS for NPC patients with and without prevertebral space involvement were 58.8％ vs.77.5％ (x2 =11.95,P =0.000),77.8％ vs.85.0％(x2=2.56,P=0.110),and 88.3％ vs.91.8％ (x2=1.51,P=0.220),respectively.After adjusting for N stage,a significant difference was still seen between the two groups with regard to 5-year OS (x2 =9.93,P =0.002).The multivariate analysis showed that prevertebral space involvement was not the independent prognostic factor for OS,DMFS,and LRFS (x2 =0.43,P =0.512 ; x2 =0.08,P =0.783 ; x2 =0.00,P =0.971).Conclusions The frequency of prevertebral space involvement is very high in NPC.The OS for the patients with prevertebral space involvement is significantly lower than those without prevertebral space involvement.But prevertebral space involvement is not the independent prognostic factor in NPC patients.