Abstract:
Objective Malignant tumor in the nasal cavity is a disease with a low incidence rate that is rarely reported.Presently, no consensus has been reached on its standard treatment and prognostic factors.This study aims to investigate effective treatment and prognostic factors through the evaluation of treatment outcomes.
Methods The records of 94 NPC patients were reviewed.Among the 94 cases, 22 received radiotherapy +/- chemotherapy, 30 underwent surgery +/- chemotherapy, 31 received radiotherapy plus surgery +/- chemotherapy, and 11 received chemotherapy only.Survival analysis was conducted using the Kaplan-Meier method, in which the differences between the groups were detected using the logrank test.Multivariate analysis was performed using the Cox proportional hazards model.
Results The overall 5-year survival rate was 58.2%.Patients below 40 years old had lower survival rate compared with those over 40 years old(P < 0.05).The 5-year survival rate in the patients with stageⅠtumor and stageⅡtumor was 84.6%, and that in the patients with stageⅢtumor and stageⅣtumor was 37.8%(P < 0.01).The patients who were initially diagnosed with cervical lymph node exhibited reduced survival rate compared with the node-negative patients.The overall 5-year survival rate of the patients treated with radiotherapy +/- chemotherapy was 51.1%, and that of the patients treated with surgery +/- chemotherapy reached 65.1%. The survival rate of the patients who underwent radiotherapy plus surgery +/- chemotherapy was 70.5%, whereas that of the patients who received simple chemotherapy was merely 18.2%(P < 0.05).Using Cox regression, clinical stage was determined as the independent prognostic factor.
Conclusion For early-stage NPC patients, no difference was found among simple surgery, radiotherapy only, and surgery combined with radiation therapy.Comprehensive treatment is preferred for patients with advanced-stage NPC, whereas simple chemotherapy may be the worst choice.Clinical staging is an independent prognostic factor for NPC patients.