Primary Tumor Volume: An Important Predictor of Outcome for T4-staged Nasopharyngeal Carcinoma

原發腫瘤體積－晚期鼻咽癌的重要預後因子

張正權(Cheng-Chuan Chang) ； 陳穆寬(Mu-Kuan Chen)

《The Changhua Journal of Medicine》 7卷3期 (2002/07) Pp. 154-159

摘要

背景及目的：即使治療方法的不斷精進，晚期鼻咽癌的預後仍不甚理想；因此，在治療前找出預後不佳的預測因子，並投予適當的治療有其急切性。
方法：以治療前的電腦斷層計算36名原發第四期鼻咽癌病人的原發腫瘤體積，並與治療結果做統計分析。
結果：以60毫升為分界將病人分為二組，結果顯示原發腫瘤體積大於60毫升的病人治療結果相當差，5年存活率13.5%。存活曲線經統計分析發現二組之差異達統計顯著性(P=0.002)。
結論：原發腫瘤體積大於60毫升的鼻咽癌病人，對目前的治療反應不佳；因此，應考慮更積極的治療方法來改善預後。

關鍵字

鼻咽癌 ； 原發腫瘤體積 ； 預測因子

並列摘要

Background and purpose: It is commonly agreed that the prognosis in advanced nasopharyngeal carcinoma (NPC) is unsatisfactory, despite aggressive treatment. Tumor volume is an important prognostic factor for patients with malignancy treated with primary radiotherapy. However, as far as we know, little is known about the prognostic value of primary tumor volume, especially in advanced T4-staged lesions.
Methods: Using the summation of area technique, 36 tumor volume estimations were performed. The probabilities of achieving tumor control and patient survival were estimated using the product-limit method of Kaplan and Meier. The log rank test was used for significance examination.
Results: A substantial variation in primary tumor volume was observed. The median primary tumor volume was 54.07ml, with a range of 6.7-223.1ml. Larger primary tumor volume was associated with a significantly poorer disease-specific survival (P=0.0022). The five-year survival rate for patients with a primary tumor volume larger than 60ml was only 13.3%.
Conclusion: To improve the treatment outcome of T4-staged NPC with large primary tumor volumes, more aggressive treatment is needed.

並列關鍵字

nasopharyngeal carcinoma ； primary tumor volume ； predictor