Risk factors for poor prognosis of intensity modulated radiotherapy for nasopharyngeal carcinoma
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目的 分析鼻咽癌患者调强放疗预后不良的危险因素，为临床防治提供依据。 方法 回顾性抽取2021年2月至2023年2月郑州大学第一附属医院收治的88例鼻咽癌患者的临床资料。所有患者均接受调强放疗治疗，根据调强放疗结束后3个月的疗效将其分为预后不良组(31例)和预后良好组(57例)。采用单因素及多因素Logistic分析法探讨鼻咽癌患者调强放疗预后不良的危险因素。 结果 鼻咽癌患者调强放疗88例中预后不良31例，发生率为35.23%。预后不良组年龄>60岁、吸烟、肿瘤分期Ⅲ期、原发灶超腔、合并贫血、基线淋巴细胞/单核细胞绝对值≤3.3、乳酸脱氢酶>185 IU/L患者比例高于预后良好组，差异有统计学意义(P<0.05)。多因素Logistic分析结果显示，肿瘤分期Ⅲ期、原发灶超腔、合并贫血、乳酸脱氢酶>185 IU/L为鼻咽癌患者调强放疗预后不良发生的危险因素(P<0.05)。 结论 鼻咽癌患者调强放疗预后不良情况不容乐观，其危险因素包括肿瘤分期Ⅲ期、原发灶超腔、合并贫血、乳酸脱氢酶>185 IU/L，临床可据此筛选高危患者并制定防治策略。 Objective To analyze the risk factors for poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma, and provide evidence for clinical prevention and treatment. Methods The clinical data of 88 patients with nasopharyngeal carcinoma admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2023 were retrospectively analyzed. All patients were treated by intensity modulated radiotherapy, and they were divided into poor prognosis group (31 cases) and good prognosis group (57 cases) according to the efficacy 3 months after intensity modulated radiotherapy. Univariate and multivariate logistic analysis were used to investigate the risk factors for poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma. Results Among the 88 patients treated by intensity modulated radiotherapy, 31 cases had poor prognosis, with an incidence of 35.23%. The proportion of patients with age > 60 years, smoking, tumor stage Ⅲ, primary lesion size over-cavity, anemia, baseline lymphocyte/monocyte absolute value ≤3.3, and lactate dehydrogenase >185 IU/L in the poor prognosis group were significantly higher than those in the good prognosis group ( P<0.05). The results of multivariate logistic analysis showed that tumor stage Ⅲ, primary lesion size over-cavity, anemia, and lactate dehydrogenase >185 IU/L were risk factors for the poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma (P<0.05). Conclusions The poor prognosis of patients with intensity modulated radiotherapy is not optimistic, and the risk factors for poor prognosis include tumor stage Ⅲ, primary lesion size over-cavity, anemia, and lactate dehydrogenase >185 IU/L. In clinical, these factors can be used to screen high-risk patients and formulate prevention and treatment strategies.
Objective To analyze the risk factors for poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma, and provide evidence for clinical prevention and treatment. Methods The clinical data of 88 patients with nasopharyngeal carcinoma admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2023 were retrospectively analyzed. All patients were treated by intensity modulated radiotherapy, and they were divided into poor prognosis group (31 cases) and good prognosis group (57 cases) according to the efficacy 3 months after intensity modulated radiotherapy. Univariate and multivariate logistic analysis were used to investigate the risk factors for poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma. Results Among the 88 patients treated by intensity modulated radiotherapy, 31 cases had poor prognosis, with an incidence of 35.23%. The proportion of patients with age > 60 years, smoking, tumor stage Ⅲ, primary lesion size over-cavity, anemia, baseline lymphocyte/monocyte absolute value ≤3.3, and lactate dehydrogenase >185 IU/L in the poor prognosis group were significantly higher than those in the good prognosis group ( P<0.05). The results of multivariate logistic analysis showed that tumor stage Ⅲ, primary lesion size over-cavity, anemia, and lactate dehydrogenase >185 IU/L were risk factors for the poor prognosis of intensity modulated radiotherapy for patients with nasopharyngeal carcinoma (P<0.05). Conclusions The poor prognosis of patients with intensity modulated radiotherapy is not optimistic, and the risk factors for poor prognosis include tumor stage Ⅲ, primary lesion size over-cavity, anemia, and lactate dehydrogenase >185 IU/L. In clinical, these factors can be used to screen high-risk patients and formulate prevention and treatment strategies.
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