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学科主题: 耳鼻咽喉科学
题名:
放疗、放化疗和放疗联合靶向治疗对鼻咽癌预后影响的分析
作者: 冯冶凝
答辩日期: 2016-05-04
导师: 肖水芳
专业: 耳鼻咽喉科学
授予单位: 北京大学
授予地点: 北京大学第一临床医学院
学位: 博士
关键词: 鼻咽肿瘤/放射疗法 ; 鼻咽肿瘤/化学疗法 ; 鼻咽肿瘤/分子靶向疗法 ; 西妥昔单抗 ; 预后
其他题名: The analysis of the influence of radiotherapy,chemoradiotherapy and radiotherapy plus cetuximab treatment on the prognosis of patients with nasopharyngeal carcinoma
分类号: R730.55
摘要:

 

目的:包括西妥昔单抗治疗在内多种因素对鼻咽癌预后影响的分析和西妥昔单抗治疗相关不良反应

方法:2008年-2015年我院收治的非角化型鼻咽癌病人,接受靶向治疗和放疗的7例,单纯放疗病人27例,放化疗22例,共56例。分析不同因素对肿物局部疗效的影响,对治疗后10-12月复发和转移,总体生存率的影响;分析靶向治疗对复发和转移风险的影响。统计各治疗方案相关副作用。

结果:治疗后10-12月肿物径线改变百分比与N分期负相关(P<0.05),相关性为-0.41。 K评分、N分期对治疗后10-12月时疾病复发或远端转移有显著影响(P<0.05)。行Logistic回归分析,仅有N是治疗后10-12月复发或转移的独立预测因子(P<0.05),OR值为3.166, 95%CI为1.065-9.141。N分期对治疗后10-12月时总体生存有显著影响(P<0.05)。7例靶向治疗病人中,除一例就诊时已侵及颅内,疾病进展并死亡,其余6例病例随访中均无局部复发或转移。使用c255病人数较少,均出现了痤疮样皮疹,但是3级以上皮疹仅1例(14%)。3级以上放疗相关皮炎比例稍高(43%),局部用药可以控制。中耳炎和神经性耳聋在靶向治疗病人比例分别为14%,29%。

结论:N分期和鼻咽癌预后相关,靶向治疗是对于鼻咽癌可以选择的治疗方法。治疗相关的副作用是可控的。

英文摘要:

 

Objectives: To analyse the influence of different prognostic factors which include cetuximab treatment on the prognosis of patients with nasopharyngeal carcinoma and cetuximab treatment acute adverse effects .
 
Methods: 56 undifferentiated nasopharyngeal carcinoma patients from 2008-2015 in our hospital were included in this study, in which were 7 patients received cetuximab and IMRT, and 49 patients received IMRT or chemoradiotherapy. The influence of different prognostic factors which include cetuximab treatment on local treatment response, on 10-12 months local recurrence and distant metastasis rate, and on 10-12 months overall survival were analyzed. And the influence of cetuximab on the risk of local recurrence and distant metastasis rate, and the acute treatment adverse effects on these patients was evaluated.

Results: 1 year local treatment response is negatively related to N stage(P<0.05). KPS score and N stage have significant influence on 1 year local recurrence and distant metastasis rate(P<0.05). Logistic regression analysis demonstrates that only N is the independent prognostic factor on 1 year local recurrence and distant metastasis rate,(P<0.05),OR 3.166, 95%CI 1.065-9.141。 N stage have significant influence on 1 year overall survival(P<0.05). 7 patients received cetuximab treatment didn’t show local recurrence or distant metastasis except for 1 case with intracranial invasion and death. Grade 3 acneiform rash in 1 case(14%). Grade 3 and 4 Radiation dermatitis (43%), well controlled under local treatment . Otitis media and SNHL  rate are 14%, 29% in cetuximab treatment patients.

Conclusion: N stage is a independent prognostic factor on NPC patients. Cetuximab is a promising treatment on NPC with well tolerated adverse effects.

 

语种: 中文
相关网址: 查看原文
内容类型: 学位论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/125266
Appears in Collections:北京大学第一临床医学院_学位论文

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作者单位: 北京大学第一临床医学院

Recommended Citation:
冯冶凝. 放疗、放化疗和放疗联合靶向治疗对鼻咽癌预后影响的分析[D]. 北京大学第一临床医学院. 北京大学. 2016.
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