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研究生:周美榮
研究生(外文):Chou mei-jung
論文名稱:預後因子對鼻咽癌患者預後評估影響的探討
論文名稱(外文):The Investigation of Prognostic Factors Affecting the Prognosis Evaluation of Nasopharyngeal Carcinoma Patient
指導教授:王愛義王愛義引用關係
指導教授(外文):Wang Ai-Yih
學位類別:碩士
校院名稱:元培科學技術學院
系所名稱:影像醫學研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:50
中文關鍵詞:預後因子鼻咽癌
外文關鍵詞:nasopharyngeal carcinomaprognostic factors
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鼻咽癌(nasopharyngeal carcinoma, NPC)是頭頸部癌症中最常見的疾病。一般統計,鼻咽癌罹患率男性為女性的兩倍,鼻咽癌在世界大多數地區的發生率都非常低(約為1/100000),但在某些族群或區域它的發生率較高。在台灣鼻咽癌每年的發生率較高約為5.4/100000,在香港中國人的族群年發生率甚至高到19.2/100000~22/100000。
在台灣癌症的死亡率一直高居第一,根據衛生署2005年的統計資料顯示,因癌症而死亡的人數為37222人,男性為23944人,女性13278人,其中因鼻咽癌死亡的有833人, 為癌症死因的第十四名,其中男性有643人,為男性癌症的死亡原因中的第十名,女性有190名,為女性癌症的死亡原因中的第十四名。本研究的目的在做鼻咽癌病人預後因子的探討,並進一步分析比較預後因子對於治療結果的影響。
實驗中收集1999年5月~2004年6月在彰化基督教醫院放射腫瘤科接受放射治療的鼻咽癌病人,共有247位,其中202位為男性(82%)、45位為女性(18 %),年齡分佈在14~87歲,而評估的預後因子包括有年齡、性別、吸煙與否、WHO分類、TNM分期、化療、與口腔黏膜變化….等。結果發現年齡(P=0.001)、診治間隔時間(P=0.010)、口腔黏膜變化(P<0.002)、淋巴劑量(P=0.001)腫瘤劑量(P=0.014)與轉移現象(P=0.00)在P值的表現上(P<0.05)都呈現有其相關性,這些分析結果
將可提供治療病人時更多的參考資訊,未來應有更長時間的追蹤以便做更進一步的分析。
關鍵詞:鼻咽癌、預後因子
Nasopharyngeal carcinoma is cancer that occurs in the nasopharynx, which is located behind the nose and above the back of the throat, is the most common disease in the head neck cancer and it is much more common in southern China. In general, men are more likely than women to develop nasopharyngeal carcinoma; the rates are twice as high in males as in females. The incidence of NPC is low in most part of the world (incidence of less than 1 per 100,000 people), however, the incidence of the disease is higher in certain population and geographical regions of the world. In Taiwan, nasopharyngeal carcinoma has a relatively high prevalence with an annual incidence rate of 5.4 per 100 000. In the Hong Kong Chinese population, the annual incidence rate is even higher at 19.2 -22 per 100 000.
Malignant neoplasm has become the leading cause of death in Taiwan. From data of health statistic of the department of health, there were 37222 deaths due to cancer, 23944 are male, 13278 are females, respectively. Eight hundred thirty three people death due to NPC. Six hundred forty three are males; it was 10th rank in death due to cancer. One hundred ninety are females; it was 14th rank in death due to cancer. In the present study were analyzed the results of intensity-modulated radiation therapy (IMRT) for patient with nasopharyngeal carcinoma and to evaluate the prognostic factors that affect the results and determine the outcome.
From May 1999 through to June 2004, 247 patients with nasopharyngeal carcinoma received radiotherapy with/without chemotherapy at the Department of Radiation Oncology, Changhua Christian Hospital, Taiwan. Two hundred and two were male (82%), 45 were female (18%). The age range was from 14 to 87. The prognosis factor assessed includes the age, sex , smoke or not , classification of WHO , TNM staging , the oral cavity mucous membrane changing…etc.
From the results the age (P=0.001), diagnostic intervals (P =0.010),oral cavity mucous membrane changing (p =0.002),lymphatic dose, cumulative dose to primary tumor (P =0.014)and metastasis(0.00) were significant prognostic factors for overall survival. Thus these analysis results can offer more reference information while treating patients, and there should be track for more time by already making further analysis in the future.
目 錄
誌謝 I
英文摘要 II
中文摘要 IV
第一章 緒論 1
1.1 前言 1
1.2 文獻回顧 10
1.3 研究目的 13
第二章 原理 14
2.1 預後因子原理 14
2.2 預後在癌症醫學的重要性 17
2.3 預後因子的分析方法 19
第三章 材料與方法 23
3.1 資料收集來源 23
3.2 SPSS 分析軟體 28
3.3 資料分析 29
第四章 結果與討論 30
第五章 結論 46
參考文獻 47
參考文獻
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