关键词: 鼻咽肿瘤, 肿瘤转移, 化放疗, 预后

Abstract: Objective　To investigate factors affecting the prognosis of treatment-naive patients with metastatic nasopharyngeal carcinoma，to provide evidence for the development of treatment strategies and inform on the prognosis of treatment-naive metastatic nasopharyngeal carcinoma.Methods　A total of 52 treatment-naive patients with metastatic nasopharyngeal carcinoma admitted to the Department of Radiotherapy，Lihuili Hospital of Ningbo Medical Center between January 2011 and September 2016 were enrolled and given chemotherapy.The patients' clinical data were recorded，and the patients were followed up until March 2017.The factors affecting the prognosis of the patients were analyzed.Results　Patients were followed up for a median of 32.3 months（range 4.4-79.8 months） and had a median survival period of 29.4 months.The 2-，3- and 5-year overall survival rates were 55.9%，45.8% and 18.5%，respectively.The 3-year overall survival rate did not significantly differ in terms of gender，age，pathologic T stage，lung metastasis，distal lymph node metastasis，number of metastatic foci，number of chemotherapy cycles，management of metastatic foci，hemoglobin level，albuminlevel，alkaline phosphatase level，fibrinogen concentration and albumin-to-alkaline phosphatase ratio（AAPR） level（P>0.05），and significantly differed in terms of pathologic N stage，bone metastasis，liver metastasis，multi-organ metastasis，short-term efficacy，radiotherapy of primary foci，lactate dehydrogenase level and D-dimer level（P<0.05）．Multivariate Cox regression analysis identified N3 stage 〔HR=6.315，95%CI（2.004，19.904）〕，liver metastasis 〔HR= 5.810，95%CI（2.200，15.341）〕，multi-organ metastasis 〔HR=3.770，95%CI（1.317，10.793）〕，non-radiotherapy of primary foci〔HR=5.537，95%CI（1.740，17.620）〕 and serum alkaline phosphatase level of 100 U/L and higher 〔HR=7.657，95%CI（2.313，25.344）〕 as the risk factors for poor prognosis（P<0.05）．Conclusion　Pathologic N stage，liver metastasis，multi-organ metastasis，radiotherapy of primary foci and alkaline phosphatase level are factors affecting the prognosis of treatment-naive patients with metastatic nasopharyngeal carcinoma.These findings may facilitate treatment options，thereby improving overall survival rates.

Key words: Nasopharyngeal neoplasms, Neoplasm metastasis, Cheomoradiotherapy, Prognosis