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中国癌症防治杂志

中国癌症防治杂志 ›› 2014, Vol. 6 ›› Issue (1): 51-56.doi: 10.3969/j.issn.1674-5671.2014.01.12

• 临床研究 • 上一篇    下一篇

鼻咽癌治疗期间血红蛋白浓度变化对局部控制的影响

  

  1. 广西医科大学研究生学院；广西医科大学附属肿瘤医院头颈肿瘤外科；广西医科大学公共卫生学院
  • 出版日期:2014-03-25 发布日期:2014-04-10
  • 通讯作者: 杨剑波 E-mail:yangjianbolz@163.com

Prognostic value of changes in hemoglobin concentration during treatment for local control of nasopharyngeal carcinoma

  • Online:2014-03-25 Published:2014-04-10

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6

摘要： 目的 探讨鼻咽癌患者治疗期间血红蛋白浓度的变化对局部控制的影响。方法 将443例鼻咽癌患者治疗期间血红蛋白浓度的变化分为血红蛋白上升组141例和血红蛋白下降组302例。前组行单纯放疗51例，放疗+化疗90例；后组予单纯放疗110例，放疗+化疗192例。放疗为常规放疗，化疗为诱导化疗和同步放化疗。分析患者血红蛋白浓度的变化与预后的关系。结果 鼻咽癌治疗期间血红蛋白上升组患者和血红蛋白下降组患者的5年无局部复发生存率分别为53.5%和37.5%（P=0.013），5年无远处转移生存率分别为58.5%和37.4%（P=0.009），5年总生存率分别为43.3%和27.7%（P=0.003）。多因素分析显示患者年龄＞60岁、治疗前和治疗期贫血、T分期及治疗期血红蛋白上升是影响鼻咽癌患者局部控制的独立预后因素。结论 鼻咽癌患者治疗期间血红蛋白浓度上升是影响局部控制的预后因素之一。

关键词: 鼻咽肿瘤, 血红蛋白, 局部控制, 预后, 放疗, 化疗

Abstract: Objective To examine whether changes in hemoglobin concentration during treatment local control therapy of nasopha-ryngeal carcinoma（NPC）can predict outcomes. Methods A total of 443 patients with NPC were classified into two groups：one group experienced an increase in hemoglobin concentration during radiotherapy（n=51）or a combination of radiotherapy and chemotherapy （n=90）；the other group experienced a decrease in hemoglobin after radiotherapy（n=110）or a combination of radiotherapy and chemotherapy （n=192）.Relationships between hemoglobin concentration changes and survival outcomes were analyzed. Results The group experiencing an increase in hemoglobin presented significantly greater rates of 5-year local relapse-free survival（53.5% vs 37.5%，P=0.013），5-year distant metastasis-free survival （58.5% vs 37.4%，P=0.009） and 5-year overall survival （43.3% vs 27.7%，P=0.003）.Multivariate analysis identified  age>60 years，patients with Anemia before and during treatmen，T staging and changes in hemoglobin concentration during treatment as independent prognostic factors for failure of local control therapy. Conclusion An increase in hemoglobin concentration during treatment is a prognostic factor for local control of NPC.

Key words: Nasopharyngeal neoplasm, Hemoglobin, Local control, Prognosis, Radiotherapy, Chemotherapy