网络首发:2013-11-20,
纸质出版:2013
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局部野放射治疗鼻咽癌骨转移病灶对患者生存风险的影响[J]. 中山大学学报(医学科学版), 2013,34(6).
Impact of Local Radiotherapy of Bone Lesions on the Survival Risk in Nasopharyngeal Carcinoma Patients with Bone Metastasis[J]. Journal of Sun Yat-sen University (Medical Sciences), 2013, 34(6).
【目的】 评估根治性放疗后骨转移鼻咽癌患者在其骨转移病灶接受局部放射治疗的生存结果。 【方法】 选取2001年2月至2004年12月期间,在中山大学肿瘤防治中心接受治疗的231例鼻咽癌骨转移病人纳入这项研究,分别采用单因素和多因素分析,对比有无接受骨转移病灶放射治疗病人的生存差异,并确定其独立预后因素。【结果】 与没有接受骨转移放射治疗的一组对比(中位生存时间: 15个月),接受骨转移病灶放射治疗的一组总生存时间明显延长(中位生存时间:25个月,P < 0.001)。与年轻组(≤ 45岁)、孤立性骨转移(单个或两个病灶),和不合并其他器官转移一样,骨转移灶放疗是本组患者的独立保护性预后因素(危险比:0.705;95%置信区间:0.536-0.928;P = 0.013)。进一步亚组分析表明,不管在孤立性骨转移、多发性骨转移、单个器官转移、多个器官转移,还是在大龄组(> 45岁),接受骨转移病灶放射治疗组的总生存时间始终优于没有接受骨转移放射治疗组(P < 0.05),但是在年轻组中例外(P = 0.403)。【结论】 对根治性放疗后骨转移鼻咽癌患者实施骨转移灶放疗可能会给患者带来生存获益,但是这个结论需要配对均衡的病例对照或随机试验进一步证实。
【Objective】 To evaluate survival outcomes of local radiotherapy of bone metastasis (bmRT) in patients with bone metastatic nasopharyngeal carcinoma (bmNPC) after radical radiotherapy. 【Methods】 A total of 231 bmNPC patients treated in Sun Yat-sen University Cancer Center (SYSUCC) between February 2001 and December 2004 were enrolled into this study. Univariate and multivariate analyses were conducted to compare the survival difference between the patients received bmRT or not and identify the independent prognostic factors. 【Results】 The group received bmRT after bone metastasis exhibited significantly better overall survival (OS) compared with another group without bmRT (median survival time [MST], 25 vs. 15 months; P < 0.001)). bmRT, as well as younger age group (≤ 45 years), oligo bone lesions (single or two lesions), and absence of other organ metastasis, was found to be an independent protective prognostic factor (hazard ratio [HR], 0.705; 95% CI, 0.536-0.928, P = 0.013). Further subgroups analysis still showed that bmRT was associated with better OS regardless of in subgroup of oligo or multiple bone lesions, single or multiple metastatic organ sites, or old age group (> 45 years) (P < 0.05), except in younger age group (P = 0.403). 【Conclusions】 bmRT may bring the survival benefit for bmNPC patients after radical radiotherapy. However, a well-balanced case-matched or randomized study is expected to identify the survival value of bmRT in bmNPC.
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