CAJ | 학술논문

目的回顾分析初诊老年鼻咽癌的放、化疗结果、不良反应和预后因素.方法 2004-2007年共202例60岁以上的初诊老年鼻咽癌患者在本院接受根治性放疗或化疗,男165例、女37例,中位年龄65岁.AJCC第六版分期标准Ⅰ期1例、Ⅱ期25例、Ⅲ期120例、Ⅳa或Ⅳb期56例.所有患者放疗剂量≥66Gy,72.3％(146例)局部进展期患者联合化疗.Cox法多因素预后分析.结果随访率为100％.5年局部控制率、区域淋巴结控制率、无远处转移生存率、无瘤生存率及总生存率分别为93％、94％、82％、74％及和67％.经多因素分析发现肿瘤T、N分期及年龄是影响总生存及无远处转移生存的预后因素(P=0.006、0.002、0.008及0.020、0.002、0.022).严重的急性不良反应包括4级放射性皮炎1例(0.5％)、放射性黏膜炎2例(1.0％)、骨髓抑制5例(2.5％).结论老年鼻咽癌患者放化疗耐受性可,针对分期较晚及一般状态较好的60～ 74岁患者应采取积极的综合治疗.
목적 회고분석초진노년비인암적방、화료결과、불량반응화예후인소.방법 2004-2007년공202례60세이상적초진노년비인암환자재본원접수근치성방료혹화료,남165례、녀37례,중위년령65세.AJCC제륙판분기표준Ⅰ기1례、Ⅱ기25례、Ⅲ기120례、Ⅳa혹Ⅳb기56례.소유환자방료제량≥66Gy,72.3％(146례)국부진전기환자연합화료.Cox법다인소예후분석.결과 수방솔위100％.5년국부공제솔、구역림파결공제솔、무원처전이생존솔、무류생존솔급총생존솔분별위93％、94％、82％、74％급화67％.경다인소분석발현종류T、N분기급년령시영향총생존급무원처전이생존적예후인소(P=0.006、0.002、0.008급0.020、0.002、0.022).엄중적급성불량반응포괄4급방사성피염1례(0.5％)、방사성점막염2례(1.0％)、골수억제5례(2.5％).결론 노년비인암환자방화료내수성가,침대분기교만급일반상태교호적60～ 74세환자응채취적겁적종합치료.
Objective To retrospectively analyze the outcomes,adverse events,and prognostic factors in elderly patients initially diagnosed with nasopharyngeal carcinoma (NPC) who receive radiotherapy and chemotherapy.Methods From January 2004 to April 2007,202 patients (over 60 years of age) initially diagnosed with NPC received radical radiotherapy or chemotherapy.These patients included 165 males (81.7％) and 37 females (18.3％),with a median age of 65 years (range 60-86 years).Of all patients,1 had stage Ⅰ NPC,25 had stage Ⅱ NPC,120 had stage Ⅲ NPC,and 56 had stage Ⅳa/Ⅳb NPC,according to the AJCC staging system (6th edition).All patients received a radiation dose of ≥66 Gy,and 146 patients (72.3％) with locally advanced NPC also received chemotherapy.The Cox model was used for multivariate analysis.Results The follow-up rate was 100％.The 5-year local control rate,regional lymph node control rate,distant metastasis-free survival (DMFS) rate,disease-free survival rate,and overall survival (OS) rate were 93％,94％,82％,74％,and 67％,respectively.The multivariate analysis revealed that T stage,N stage,and age were prognostic factors for OS and DMFS (P =0.006,0.002,and 0.008 ;P =0.020,0.002,and 0.022).The severe acute toxicities included grade 4 radiation dermatitis (1 patient,0.5％),grade 4 radiation mucositis (2 patients,1.0％),and grade 4 bone marrow suppression (5 patients,2.5％).Conclusions The elderly NPC patients can tolerate radiotherapy and chemotherapy well.Multimodality therapy should be adopted for the patients aged 60-74 years who have advanced-stage NPC and good general conditions.