[Statistical analysis of 32 patients with nasopharyngeal carcinoma].
[Statistical analysis of 32 patients with nasopharyngeal carcinoma].
复制标题
32例鼻咽癌患者的统计分析
DOI：
10.3950/jibiinkoka.115.773
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
K. Ogawa
中科院分区：
文献类型：
--
作者：
Ryoichi Fujii;Y. Imanishi;T. Tomita;K. Sakamoto;S. Shigetomi;Noboru Habu;K. Ootsuka;Yoichiro Sato;Hiroyuki Ozawa;T. Yamashita;M. Fujii;N. Shigematsu;K. Ogawa
无标签
为了评估1997-2006年间庆应大学医学院耳鼻咽喉头颈外科收治的鼻咽癌患者的临床转归和预后因素，对患者的病历资料进行了统计分析。采用Kaplan-Meier方法估计所有病例(I~IV期，n=32)和晚期病例(III、IV期，n=22)的病因特异性生存率(CS)和无病生存率(DFS)。采用多因素COX比例风险模型确定临床因素和治疗因素的独立预后价值。
结果
5年总有效率为43.4%/34.8%，晚期为34.5%/29.8%。多因素分析显示，在所有病例中，年龄(>；or=61 vs.<；；OR=60，风险比(RR)=5.717，p=0.006)，T期(3/4vs.1/2，RR=6.957，p=0.004)，以及铂类药物的使用(未用与已用，RR=3.911，p=0.012)，而DFS组为T期(3/4vs.1/2，RR=3.499，p=0.019)和使用铂类药物(未用与已用，RR=2.947，p=0.028)。在晚期病例中，单独使用铂类药物对慢性粒细胞白血病(RR=4.503，p=0.023)和完全缓解(RR=4.218，p=0.014)均有显著意义。在单因素分析(对数等级检验)中，接受新辅助化疗的患者比未接受新辅助化疗的患者有更好的生活质量和无病生存率(分别为p=0.066和p=0.025)，尽管在多因素分析中这两组患者之间没有显著差异。
结论
即使在样本量较小的研究中，铂类药物在鼻咽癌治疗中的优势也得到了统计上的证实。作为化疗和放射治疗相结合的药物，多西他赛单独的疗效似乎不能与铂类药物相提并论。多西紫杉醇-顺铂-5-氟尿嘧啶方案作为NAC方案治疗晚期鼻咽癌可能是有益的。
UNLABELLED
In order to assess the clinical outcome and prognostic factors of patients with nasopharyngeal carcinoma (NPC) who were initially treated in the Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine between 1997 and 2006, statistical analyses were performed based on the patient medical records. Cause-specific survival (CSS) and disease-free survival (DFS) in all cases (stage I to IV, n = 32) and advanced cases (stage III and IV, n = 22) were estimated using the Kaplan-Meier method. The independent prognostic values of the clinical and therapeutic factors were determined using multivariate Cox proportional hazards models.
RESULTS
The 5-year CSS/DFS were 43.4%/34.8% in all cases and 34.5%/29.8% in advanced cases. Multivariate analysis revealed that, in all cases, the independent prognostic factors for CSS were age (> or = 61 vs. < or = 60, risk ratio (RR) = 5.717, p = 0.006), T-stage (3/4 vs. 1/2, RR = 6.957, p = 0.004), and the use of platinum agents (unused vs. used, RR = 3.911, p = 0.012), whereas those for DFS were T-stage (3/4 vs. 1/2, RR = 3.499, p = 0.019) and the use of platinum agents (unused vs. used, RR = 2.947, p = 0.028). In advanced cases, the use of platinum agents alone was significant for both CSS (RR = 4.503, p = 0.023) and DFS (RR = 4.218, p = 0.014). The patients who received neoadjuvant chemotherapy (NAC) showed better CSS and DFS than the patients who did not (p = 0.066 and p = 0.025, respectively) in a univariate analysis (Log-rank test), although no significant difference was seen between these groups in the multivariate analysis.
CONCLUSION
The advantage of the administration of platinum agents in the treatment of NPC was statistically corroborated even in our study with its small sample size. As agents combined with chemoradiotherapy, the efficacy of docetaxel alone did not seem comparable to that of platinum agents. The docetaxel-CDDP-5-FU regimen applied as NAC was suggested to be possibly beneficial for advanced cases of NPC.