- 期刊
第四期鼻咽癌的預後因子
Prognostic Factors of Stage Iv Nasopharyngeal Cancer
摘要
目的：評估第四期鼻咽癌的治療成效與其預後因子。 材料與方法：從1991年4月至1995年6月間，高雄榮民總醫院共有89名可評估的T1-4N2-3MO鼻咽癌患者。所有89名患者都接受了治療性放射線治療；其中僅劑量為7200cGy在（範圍為6800至7670cGyl）.本研究除計算治療後之存活率外，亦分析T及N期別與失敗型態的關系。可能影響預後的因子均先以單變異數方法分析；有意義的預後因子再以多變異數方法分析。 結果：五年存活率、局部控制存活率與疾病控制存活率分別為43.7%、44.6%及40.3%。以單變異數方法分析，本研究發現T期別、T4腫瘤侵犯特徵、總治療時間、淋巴結放療反應、T/N期別組合、性別及血小板等均為有意義之預後因子。以多變異數方法分析，則只有T4腫瘤侵犯特徵會影響存活率，T/N期別繃帶 合會影響局部控制存活率。 結論：本研究發現第四期鼻咽癌患者的治療成果會隨不同預後因子而有所差異。以後在決定此期癌病的治療方針時，可攷慮依照不同的預後因子來規劃與設計不同的治療方式，以提高治療成效。
並列摘要
Purpose: To evaluate the results and prognostic factors of Stage IV nasopharyngeal cancer. Methods and Materials: From April 11191 to June 1995, 89 patients with Tl-4 N2-3M0 nasopharyngeal cancer treated at the Veteran General Hospital-Kaohsiung were evaluated. All these patients had received definitive radiotherapy to a median dose of 7200 cGy (range from 6800 to 7670 cGy). The failure patterns according to different T and N stages were evaluated. The possible prognostic factors were analysed by univariate analysis first, then those have significant p values were further eveluated by multivariate analysis. Results: The survival rate, local failure free survival and disease-free survival at 5 years were 43.7%, 44.6% and 40.3%, respectively. The factors including T stage, characteristics of T4 invasion, total treatment time, lymph node response rate, T and N grouping, sex and platelet counts all showed statistically significance by univariate analysis. The multivariate analysis revealed both the characteristics of T4 invasion and T/N grouping are significant to the overall survival and local failure free survival, respectively. Conclusion: This study disclosed that the patients with Stage IV nasopharyngeal cancer have different prognosis according to different factors. In the future, we might design treatment policies according to different prognostic factors in an attempt to improve the treatment results.
延伸閱讀
- Hung, L. C., Liu, M. T., Chen, M. K., Chang, C. C., Huang, C. C., Huang, C. Y., Pi, C. P., Chang, T. H., & Hsu, C. C. (2008). 口咽癌之治療結果與預後因子分析. 放射治療與腫瘤學, 15(3), 167-179. https://doi.org/10.6316/TRO/200815(3)167
- Chen, P. Y., Yang, S. N., Liang, J. A., & Tsai, M. H. (2007). 下咽癌之放射治療結果與預後因子分析. 放射治療與腫瘤學, 14(2), 63-73. https://doi.org/10.6316/TRO/200714(2)63
- 鄭中浩（2013）。應用類神經網路預測鼻咽癌病人之五年存活狀態〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2013.00039
- 鄭中浩、鄭鴻鈞、邱泓文（2013）。應用類神經網路預測鼻咽癌病人之五年存活狀態。放射治療與腫瘤學，20(3)，191-197。https://doi.org/10.6316/TRO/201320(3)191
- 黃志銘（2006）。Treatment Outcomes and Medical Utilization of Nasopharyngeal Cancer〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-3107200611184300