鼻咽癌侵犯颅底对肿瘤复发转移以及后遗症的影响.docVIP

精品论文 参考文献 鼻咽癌侵犯颅底对肿瘤复发转移以及后遗症的影响 刘琦 赖庆君 朱介宾 张纯 　　（东莞市人民医院肿瘤内科 广东 东莞 523000） 　　【摘 要】目的：探讨鼻咽癌侵犯颅底对肿瘤复发转移以及放疗后后遗症的影响。方法：回顾性分析我院住院治疗的鼻咽癌患者，分析鼻咽癌颅底受侵发生的情况，对放疗的反应，放疗后肿瘤复发和转移的情况，以及放疗后后遗症的发生。结果：入组鼻咽癌277例，侵犯颅底149例，未侵犯颅底128例。两组患者初治时即发生远处转移者分别为15例和2例，有统计学差异（p=0.003＜0.01）。经放射治疗后颅底未受侵组鼻咽肿瘤均完全消失，而颅底受侵组有8例患者鼻咽肿瘤MRI提示有残留(p=0.008＜0.01)。经过定期随访，颅底受侵组鼻咽局部复发38例，颅底未受侵组鼻咽局部复发5例，两组间有统计学差异（p=0.000＜0.001）；随访那些初治时无远处转移的鼻咽癌患者，颅底受侵组和颅底未受侵组发生远处转移分别为37和28例，两组间没有统计学差异（p=0.563）。鼻咽癌放疗后颅底受侵组放射性脑病的发生较未受侵组为高（p=0.014＜0.05），而两组间炎性水肿的发生没有统计学差异（p=0.071）。结论：鼻咽癌侵犯颅底患者治疗后局部肿瘤复发和放射性脑病发生均升高，但是治疗后远处转移发生的几率并没有增加。 　　【中图分类号】R739.6 【文献标识码】A 【文章编号】1004-6194（2015）01-0163-02 　　The correlation of skull base erosion of nasopharyngeal carcinoma with cancer recurrence, metastasis and radiation sequela 　　Liu Qi, Lai Qingjun, Zhu Jiebing, Zhang Chun 　　Department of Medical Oncology, Dongguan Peoplersquo;s Hospital，Dongguan 523000,China 　　【Abstract】Objective：To study the correlation of skull base erosion of nasopharyngeal carcinoma(NPC) with cancer recurrence, metastasis and radiation sequela after radiation. Methods：A total of 277 patients who were diagnosed with NPC between 2010 and 2013 were included in this study. MRI images and medical records were analyzed retrospectively．Difference between skull base erosion was analyzed using the ⅹ2 test. Results：277 NPC patients included 149 patients with skull base erosion (53.79%) and 128 patients without erosion (46.21%). Whether or not skull base was invaded, patients developed distant metastases have statistics significance (p=0.003＜0.01). After radiation, the complete response rate in skull base erosion group was 5.37% and 100% in without erosion group at the end of the course (p=0.008＜0.01). Patients relapsed at the primary site were higher in skull base erosion group (p=0.000＜0.001). But no statistically significant distant metastases were seen between two different groups (p=0.563＞0.05). After radiation, radiation encephalopathy were higher in skull base erosi