【摘要】：鼻咽癌是我國(guó)常見(jiàn)的惡性腫瘤之一,在頭頸部惡性腫瘤中占首位。其病變首發(fā)于鼻咽粘膜上皮,向上可侵及顱底,向下可轉(zhuǎn)移到頸部淋巴結(jié),臨床表現(xiàn)復(fù)雜多變,易被患者及醫(yī)務(wù)人員忽略及誤診、漏診。放射治療為目前首選治療手段。近年來(lái),國(guó)內(nèi)外分子生物學(xué)、細(xì)胞遺傳學(xué)、免疫學(xué)、放射生物學(xué)、物理學(xué)等基礎(chǔ)醫(yī)學(xué)迅速發(fā)展,為臨床制訂鼻咽癌綜合治療方案提供了保障。隨著治療方法的不斷改進(jìn),鼻咽癌的治療效果已有明顯提高。本研究對(duì)487名住院鼻咽癌患者進(jìn)行隨訪(fǎng),探討各種因素對(duì)患者生存率的影響。 本研究選取487例鼻咽癌患者,男性369例,女性118例,男女比例為3.13:1;最小患病年齡為7歲,最高患病年齡為81歲,患者中位患病年齡為48歲�；颊呔邮芊派渲委�,并或接受化學(xué)治療。結(jié)果顯示,男性患者的5年生存率明顯低于女性;各年齡組之間5年生存率均無(wú)統(tǒng)計(jì)學(xué)差異;不同TNM分期及臨床分期患者的5年生存率有統(tǒng)計(jì)學(xué)差異;T、N及臨床分期越高,生存率越低。而鼻咽區(qū)放射治療劑量對(duì)鼻咽癌預(yù)后也有一定的影響,但無(wú)統(tǒng)計(jì)學(xué)差異。常規(guī)治療組和三維適形治療組比較,三維適形治療組5年生存率明顯提高。同步放化療比誘導(dǎo)化療、輔助化療結(jié)合放射治療、單純放射治療的模式,5年生存率均明顯提高。通過(guò)對(duì)影響鼻咽癌預(yù)后的相關(guān)因素進(jìn)行多因素Logistic回歸分析,顯示,性別,疾病分期及治療技術(shù)和放化療聯(lián)合治療方法與鼻咽癌的預(yù)后密切相關(guān),本研究將為鼻咽癌的臨床治療提供有意義的參考。
[Abstract]:Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in China. Its first lesion is nasopharynx mucosal epithelium, which can invade skull base up and transfer down to cervical lymph node. Its clinical manifestation is complicated and changeable, which is easy to be neglected and misdiagnosed by patients and medical staff. Radiotherapy is the first choice at present. In recent years, molecular biology, cytogenetics, immunology, radiobiology, physics and other basic medicine have developed rapidly at home and abroad. With the improvement of treatment method, the therapeutic effect of nasopharyngeal carcinoma has been improved obviously. In this study, 487 inpatients with nasopharyngeal carcinoma were followed up to explore the influence of various factors on the survival rate. In this study, 487 patients with nasopharyngeal carcinoma (NPC) were selected, 369 males and 118 females, the ratio of males to females was 3.13: 1, the minimum age was 7 years old, the highest age was 81 years old, the median age of the patients was 48 years old. All patients received radiotherapy or chemotherapy. The results showed that the 5-year survival rate of male patients was significantly lower than that of females, there was no significant difference in 5-year survival rate among different age groups, and the 5-year survival rate of patients with different TNM stages and clinical stages was significantly higher than that of female patients. The lower the survival rate. The radiotherapy dose in nasopharyngeal area also affected the prognosis of nasopharyngeal carcinoma, but there was no statistical difference. The 5-year survival rate of three-dimensional conformal therapy group was significantly higher than that of 3-d conformal therapy group. Compared with induction chemotherapy, adjuvant chemotherapy combined with radiotherapy, radiotherapy alone, 5-year survival rate was significantly improved. Multivariate Logistic regression analysis showed that sex, disease stage, treatment techniques and combined radiotherapy and chemotherapy were closely related to the prognosis of nasopharyngeal carcinoma. This study will provide a valuable reference for the clinical treatment of nasopharyngeal carcinoma.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R739.63

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本文編號(hào)：2210675