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肿瘤体积对局部晚期鼻咽癌预后影响的倾向匹配研究

胡勇, 张晶晶, 岳成山, 刘亚军, 王会霞, 高山, 张强, 张蕾, 袁亮

胡勇, 张晶晶, 岳成山, 刘亚军, 王会霞, 高山, 张强, 张蕾, 袁亮. 肿瘤体积对局部晚期鼻咽癌预后影响的倾向匹配研究[J]. 实用临床医药杂志, 2020, 24(20): 51-54. DOI: 10.7619/jcmp.202020014
引用本文: 胡勇, 张晶晶, 岳成山, 刘亚军, 王会霞, 高山, 张强, 张蕾, 袁亮. 肿瘤体积对局部晚期鼻咽癌预后影响的倾向匹配研究[J]. 实用临床医药杂志, 2020, 24(20): 51-54. DOI: 10.7619/jcmp.202020014
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HU Yong, ZHANG Jingjing, YUE Chengshan, LIU Yajun, WANG Huixia, GAO Shan, ZHANG Qiang, ZHANG Lei, YUAN Liang. Effect of tumor volume on prognosis of patients with local advanced nasopharyngeal carcinoma: a propensity-matched study[J]. Journal of Clinical Medicine in Practice, 2020, 24(20): 51-54. DOI: 10.7619/jcmp.202020014
Citation: HU Yong, ZHANG Jingjing, YUE Chengshan, LIU Yajun, WANG Huixia, GAO Shan, ZHANG Qiang, ZHANG Lei, YUAN Liang. Effect of tumor volume on prognosis of patients with local advanced nasopharyngeal carcinoma: a propensity-matched study[J]. Journal of Clinical Medicine in Practice, 2020, 24(20): 51-54. DOI: 10.7619/jcmp.202020014
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肿瘤体积对局部晚期鼻咽癌预后影响的倾向匹配研究

  • 陕西省汉中市中心医院, 1. 放疗科, 2. 肿瘤内科, 陕西 汉中, 723000

详细信息
    通讯作者:

    袁亮, E-mail: uniqueyuanliang@163.com

  • 中图分类号: R739.6

Effect of tumor volume on prognosis of patients with local advanced nasopharyngeal carcinoma: a propensity-matched study

  • 1. Department of Radiotherapy, 2. Department of Oncology, Central Hospital of Hanzhong City in Shaanxi Province, Hanzhong, Shaanxi, 723000

摘要

    摘要
  • 摘要: 目的 探讨肿瘤体积(GTV)对局部晚期鼻咽癌患者预后的影响。 方法 分析310例接受放化疗的Ⅲ~ⅣA/B期鼻咽癌患者的临床资料及随访资料,以受试者工作特征(ROC)曲线确定治疗前GTV最佳界值为34.1 mL, 选取GTV>34.1 mL患者106例纳入实验组,依据年龄、性别、卡氏功能状态量表(KPS)评分、T分期、N分期、临床分期采用倾向值匹配法,获得106例(1∶1匹配)GTV≤34.1 mL患者纳入对照组。采用Kaplan-Meier法计算生存率,以Cox回归模型进行预后因素分析。主要研究终点为无局部-区域进展生存率(LRRFS),次要研究终点为总生存率(OS)和无远处转移生存率(DMFS)。 结果 实验组4年LRRFS(80.2%)低于对照组(92.5%), 4年OS(77.4%)低于对照组(84.0%), 差异有统计学意义(P=0.008、0.043); 实验组与对照组4年DMFS分别为68.9%、74.5%, 差异无统计学意义(P=0.273); Cox回归模型显示, GTV>34.1 mL是LRRFS和OS的不良影响因素。 结论 GTV>34.1 mL是局部晚期鼻咽癌患者局部-区域进展和死亡的不良影响因素,对此类患者需增大治疗强度,以获得更好的临床疗效。
    Abstract: Objective To evaluate the primary gross tumor volume(GTV)on prognosis in patients with local advanced nasopharyngeal carcinoma. Methods The clinical data and follow-up data of 310 patients with nasopharyngeal carcinoma in Ⅲ to IVA/B phase undergoing chemoradiotherapy were retrospectively analyzed. The optimized critical value of GTV was confirmed as 34.1 mL by Receiver Operating Characteristic(ROC)curve analysis. A total of 106 cases with GTV>34.1 mL were included in the experimental group. Propensity matched study method was used to adjust for age, gender, Karnofsky Performance Status(KPS), tumor stage, node stage, and clinical stage. At last, a well-balanced cohort(106 cases who had GTV of less or equaling to 34.1 mL)was created by 1∶1 matching in the control group. Survival rate was calculated using Kaplan-Meier method, and prognostic factors were analyzed using Cox regression model. The primary end-point was loco-regional relapse-free survival rate(LRRFS), secondary end-points were overall survival(OS)and distant metastasis-free survival(DMFS). Results The experimental group had lower 4-year LRRFS and OS when compared to the control group(80.2% versus 92.5%, 77.4% versus 84.0%, P=0.008, 0.043). The 4-year DMFS of the experimental group and the control group were 68.9% and 74.5%, respectively, but no significant difference was found(P=0.273). Cox regression model showed that GTV >34.1 mL was an adverse influencing factor of LRRFS and OS. Conclusion GTV>34.1 mL is an adverse influencing - factor for loco-regional progress and death in local advanced nasopharyngeal carcinoma. It is necessary to increase the treatment intensity in order to obtain better clinical efficacy.
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出版历程
  • 收稿日期:  2020-08-17
  • 网络出版日期:  2020-12-21
  • 发布日期:  2020-11-12

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