国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
Journal of International Oncology
2015年
10期
726-729
,共4页
韦存志%蔡德丰%屈进文%肖世强%王建洪
韋存誌%蔡德豐%屈進文%肖世彊%王建洪
위존지%채덕봉%굴진문%초세강%왕건홍
黏液表皮样瘤%治疗结果%预后
黏液錶皮樣瘤%治療結果%預後
점액표피양류%치료결과%예후
Mucoepidermoid tumor%Treatment outcome%Prognosis
目的:探讨术后辅助放化疗对腮腺黏液表皮样癌患者的疗效,并进一步筛选出与肿瘤预后有关的指标。方法选取2005年1月—2009年12月在四川省宜宾市第一人民医院治疗的80例腮腺黏液表皮样癌患者作为研究对象,回顾性分析单纯手术(30例)或术后辅助治疗(50例)患者的生存情况,并进一步分析患者年龄、性别、吸烟、饮酒、淋巴结转移情况、远隔脏器转移情况、治疗方法、分化程度和 T 分级等变量与患者预后的关系。结果Kaplan-Meier 生存曲线显示,术后辅助放化疗患者的 PFS和 OS 均长于单纯手术治疗患者(94.4个月∶69.3个月;114.9个月∶96.7个月),差异均有统计学意义(χ2=11.246,P =0.001;χ2=15.803,P =0.001)。COX 单因素分析结果表明,性别(χ2=22.346,P =0.000)、吸烟(χ2=7.891,P =0.041)、淋巴结转移(χ2=12.371,P =0.005)、远隔脏器转移(χ2=9.813, P =0.002)、治疗方法(χ2=25.261,P =0.000)、分化程度(χ2=4.361,P =0.006)和 T 分级(χ2=5.336, P =0.014)与患者 PFS 有关。进一步多因素分析发现,淋巴结转移(χ2=11.003,RR =2.827,95%CI 为1.965~3.851,P =0.011)、远隔脏器转移(χ2=7.611,RR =0.472,95%CI 为0.240~0.775,P =0.016)、治疗方法(χ2=24.542,RR =5.390,95%CI 为3.585~9.602,P =0.000)、分化程度(χ2=3.221,RR =2.118,95%CI 为1.845~4.719,P =0.009)和 T 分级(χ2=4.336,RR =0.804,95%CI 为0.681~0.916, P =0.024)与患者 PFS 有关。COX 单因素分析结果表明,吸烟(χ2=4.551,P =0.008)、饮酒(χ2=11.742,P =0.048)、淋巴结转移(χ2=14.886,P =0.009)、远隔脏器转移(χ2=6.713,P =0.005)、治疗方法(χ2=22.411,P =0.000)、分化程度(χ2=8.116,P =0.012)和 T 分级(χ2=14.443,P =0.035)与患者OS 有关。进一步多因素分析发现淋巴结转移(χ2=11.711,RR =2.985,95%CI 为1.521~3.999,P =0.005)、远隔脏器转移(χ2=5.390,RR =0.400,95%CI 为0.201~0.793,P =0.009)、治疗方法(χ2=19.327,RR =5.086,95%CI为3.241~8.006,P =0.000)、分化程度(χ2=7.084,RR =2.301,95%CI 为1.908~4.503,P =0.001)和 T 分级(χ2=13.229,RR =0.561,95%CI 为0.348~0.867,P =0.040)与患者 OS 有关。结论术后辅助放化疗能明显延长腮腺黏液表皮样癌患者的 PFS 和 OS。淋巴结转移、远隔脏器转移、治疗方法、分化程度和 T 分级对腮腺黏液表皮样癌患者的预后具有较大的影响,可以作为腮腺黏液表皮样癌患者预后的独立指标。
目的:探討術後輔助放化療對腮腺黏液錶皮樣癌患者的療效,併進一步篩選齣與腫瘤預後有關的指標。方法選取2005年1月—2009年12月在四川省宜賓市第一人民醫院治療的80例腮腺黏液錶皮樣癌患者作為研究對象,迴顧性分析單純手術(30例)或術後輔助治療(50例)患者的生存情況,併進一步分析患者年齡、性彆、吸煙、飲酒、淋巴結轉移情況、遠隔髒器轉移情況、治療方法、分化程度和 T 分級等變量與患者預後的關繫。結果Kaplan-Meier 生存麯線顯示,術後輔助放化療患者的 PFS和 OS 均長于單純手術治療患者(94.4箇月∶69.3箇月;114.9箇月∶96.7箇月),差異均有統計學意義(χ2=11.246,P =0.001;χ2=15.803,P =0.001)。COX 單因素分析結果錶明,性彆(χ2=22.346,P =0.000)、吸煙(χ2=7.891,P =0.041)、淋巴結轉移(χ2=12.371,P =0.005)、遠隔髒器轉移(χ2=9.813, P =0.002)、治療方法(χ2=25.261,P =0.000)、分化程度(χ2=4.361,P =0.006)和 T 分級(χ2=5.336, P =0.014)與患者 PFS 有關。進一步多因素分析髮現,淋巴結轉移(χ2=11.003,RR =2.827,95%CI 為1.965~3.851,P =0.011)、遠隔髒器轉移(χ2=7.611,RR =0.472,95%CI 為0.240~0.775,P =0.016)、治療方法(χ2=24.542,RR =5.390,95%CI 為3.585~9.602,P =0.000)、分化程度(χ2=3.221,RR =2.118,95%CI 為1.845~4.719,P =0.009)和 T 分級(χ2=4.336,RR =0.804,95%CI 為0.681~0.916, P =0.024)與患者 PFS 有關。COX 單因素分析結果錶明,吸煙(χ2=4.551,P =0.008)、飲酒(χ2=11.742,P =0.048)、淋巴結轉移(χ2=14.886,P =0.009)、遠隔髒器轉移(χ2=6.713,P =0.005)、治療方法(χ2=22.411,P =0.000)、分化程度(χ2=8.116,P =0.012)和 T 分級(χ2=14.443,P =0.035)與患者OS 有關。進一步多因素分析髮現淋巴結轉移(χ2=11.711,RR =2.985,95%CI 為1.521~3.999,P =0.005)、遠隔髒器轉移(χ2=5.390,RR =0.400,95%CI 為0.201~0.793,P =0.009)、治療方法(χ2=19.327,RR =5.086,95%CI為3.241~8.006,P =0.000)、分化程度(χ2=7.084,RR =2.301,95%CI 為1.908~4.503,P =0.001)和 T 分級(χ2=13.229,RR =0.561,95%CI 為0.348~0.867,P =0.040)與患者 OS 有關。結論術後輔助放化療能明顯延長腮腺黏液錶皮樣癌患者的 PFS 和 OS。淋巴結轉移、遠隔髒器轉移、治療方法、分化程度和 T 分級對腮腺黏液錶皮樣癌患者的預後具有較大的影響,可以作為腮腺黏液錶皮樣癌患者預後的獨立指標。
목적:탐토술후보조방화료대시선점액표피양암환자적료효,병진일보사선출여종류예후유관적지표。방법선취2005년1월—2009년12월재사천성의빈시제일인민의원치료적80례시선점액표피양암환자작위연구대상,회고성분석단순수술(30례)혹술후보조치료(50례)환자적생존정황,병진일보분석환자년령、성별、흡연、음주、림파결전이정황、원격장기전이정황、치료방법、분화정도화 T 분급등변량여환자예후적관계。결과Kaplan-Meier 생존곡선현시,술후보조방화료환자적 PFS화 OS 균장우단순수술치료환자(94.4개월∶69.3개월;114.9개월∶96.7개월),차이균유통계학의의(χ2=11.246,P =0.001;χ2=15.803,P =0.001)。COX 단인소분석결과표명,성별(χ2=22.346,P =0.000)、흡연(χ2=7.891,P =0.041)、림파결전이(χ2=12.371,P =0.005)、원격장기전이(χ2=9.813, P =0.002)、치료방법(χ2=25.261,P =0.000)、분화정도(χ2=4.361,P =0.006)화 T 분급(χ2=5.336, P =0.014)여환자 PFS 유관。진일보다인소분석발현,림파결전이(χ2=11.003,RR =2.827,95%CI 위1.965~3.851,P =0.011)、원격장기전이(χ2=7.611,RR =0.472,95%CI 위0.240~0.775,P =0.016)、치료방법(χ2=24.542,RR =5.390,95%CI 위3.585~9.602,P =0.000)、분화정도(χ2=3.221,RR =2.118,95%CI 위1.845~4.719,P =0.009)화 T 분급(χ2=4.336,RR =0.804,95%CI 위0.681~0.916, P =0.024)여환자 PFS 유관。COX 단인소분석결과표명,흡연(χ2=4.551,P =0.008)、음주(χ2=11.742,P =0.048)、림파결전이(χ2=14.886,P =0.009)、원격장기전이(χ2=6.713,P =0.005)、치료방법(χ2=22.411,P =0.000)、분화정도(χ2=8.116,P =0.012)화 T 분급(χ2=14.443,P =0.035)여환자OS 유관。진일보다인소분석발현림파결전이(χ2=11.711,RR =2.985,95%CI 위1.521~3.999,P =0.005)、원격장기전이(χ2=5.390,RR =0.400,95%CI 위0.201~0.793,P =0.009)、치료방법(χ2=19.327,RR =5.086,95%CI위3.241~8.006,P =0.000)、분화정도(χ2=7.084,RR =2.301,95%CI 위1.908~4.503,P =0.001)화 T 분급(χ2=13.229,RR =0.561,95%CI 위0.348~0.867,P =0.040)여환자 OS 유관。결론술후보조방화료능명현연장시선점액표피양암환자적 PFS 화 OS。림파결전이、원격장기전이、치료방법、분화정도화 T 분급대시선점액표피양암환자적예후구유교대적영향,가이작위시선점액표피양암환자예후적독립지표。
Objective To study the therapeutic effect of adjuvant chemotherapy and radiotherapy after operation in patients with mucoepidermoid carcinoma of parotid gland,and to screen the indicators ralated to the prognosis of tumor.Methods Eighty patients with mucoepidermoid carcinoma of parotid gland in First People′Hospital of Yibin of Sichuan Province from January 2005 to December 2009 were analysed retrospectively in our research.We studied the survival of patients who were treated wtih simple operation(30 cases)or postoperative adjuvant therapy(50 cases).Then we further analyzed the relationships between the prognosis of the patients and some variables (age,gender,smoking,alcohol drinking,lymph node metastasis,distant organ metastasis,treat-ment method,differentiation degree and T grading).Results Kaplan-Meier survival curves showed that patients with postoperative adjuvant therapy had longer PFS and OS than those without adjuvant therapy (94.4 months vs 69.3 months;114.9 months vs 96.7 months),with statistical significance (χ2 =11 .246,P =0.001 ;χ2 =15.803,P =0.001 ).COX univariate analysis showed that gender (χ2 =22.346,P =0.000),smoking (χ2 =7.891 ,P =0.041 ),lymph node metastasis (χ2 =12.371 ,P =0.005),distant organ metastasis (χ2 =9.81 3, P =0.002),treatment method (χ2 =25.261 ,P =0.000),differentiation degree (χ2 =4.361 ,P =0.006)and T grading (χ2 =5.336,P =0.01 4)were related to the PFS of patients.COX multivariate analysis showed that lymph node metastasis (χ2 =11 .003,RR =2.827,95%CI:1 .965-3.851 ,P =0.011 ),distant organ metastasis (χ2 =7.611 ,RR =0.472,95%CI:0.240-0.775,P =0.016),treatment method (χ2 =24.542,RR =5.390, 95%CI:3.585-9.602,P =0.000),degree of differentiation (χ2 =3.221 ,RR =2.1 1 8,95%CI:1 .845-4.719, P =0.009)and T grading (χ2 =4.336,RR =0.804,95%CI:0.681 -0.916,P =0.024)were related to the PFS of patients.COX univariate analysis showed that smoking (χ2 =4.551 ,P =0.008),alcohol drinking (χ2 =11 .742,P =0.048),lymph node metastasis (χ2 =14.886,P =0.009),distant organ metastasis (χ2 =6.71 3, P =0.005),treatment method (χ2 =22.411 ,P =0.000),degree of differentiation (χ2 =8.1 16,P =0.012)and T grading (χ2 =14.443,P =0.035)were related to the OS of patients.COX multivariate analysis showed that lymph node metastasis (χ2 =11 .711 ,RR =2.985,95%CI:1 .521 -3.999,P =0.005),distant organ metastasis (χ2 =5.390,RR =0.400,95%CI:0.201 -0.793,P =0.009),treatment method (χ2 =19.327,RR =5.086, 95%CI:3.241 -8.006,P =0.000),degree of differentiation (χ2 =7.084,RR =2.301 ,95%CI:1 .908-4.503, P =0.001 )and T grading (χ2 =1 3.229,RR =0.561 ,95%CI:0.348-0.867,P =0.040)were related to the OS of patients.Conclusion Adjuvant radiation and chemotherapy can obviously prolong the PFS and OS for the patients with mucoepidermoid carcinoma of parotid gland.Lymph node metastasis,distant organ metastasis,treat-ment method,differentiation degree and T grading can greatly influence the prognosis of patients with mucoepider-moid carcinoma of parotid gland,which can be used as independent prognostic indicators for the patients with mucoepidermoid carcinoma of parotid gland.