T3～T4N0～N3期鼻咽癌单纯放疗疗效分析  

Radiotherapy alone for T3～T4N0～N3 nasopharyngeal carcinoma

作　　者：陈春燕[1] 卢泰祥[1] 赵充[1] 孙颖[1] 卢丽霞[1] 韩非[1] 刘秀芳[1] 

机构地区：[1]中山大学肿瘤防治中心放疗科,广州510060

出　　处：《中华放射肿瘤学杂志》2006年第2期77-80,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 探讨不同T分期与N分期对局部晚期鼻咽癌单纯放疗疗效的影响。方法 回顾分析556例T3～T4N0～N3期（1992年福州分期）鼻咽癌初治患者临床资料。全组病例均采用面颈联合野照射技术给予单纯常规放疗。原发灶照射总剂量66～80Gy（6.5～8．0周完成），颈淋巴结转移灶照射总剂量60～70Gy（6～7周完成）。结果 全组病例5年总生存率为66．4％。T3期5年总生存率为69．1％，T4期的为59.0％（P〈0．05）；两者局部控制率、无瘤生存率、无复发生存率以及无转移生存率均无差别。N0、N1、N2、N3期的5年总生存率分别为74．0％、66．0％、57．6％、29．4％（P〈0．01），N分期越高复发率和远处转移率越高。结论 单纯常规放疗的局部晚期鼻咽癌患者中。N分期是影响疗效及预后的主要因素，T分期为次要因素。对不同N分期的局部晚期鼻咽癌患者进行分层放化疗，对于解决治疗失败的原因——复发与远处转移也许会起到积极和有效的作用。Objective To discuss the impact of different T and N stages for local-regional advanced nasopharyngeal carcinoma（NPC） on the clinical gains of radiotherapy（RT） alone. Methods From January to December in 1999, the data of 556 patients with 92＇ Fuzhou Staging System T3-4N0-3 in China were initially treated by conventional RT alone with the facio-cervical field were retrospectively reviewed. The total dose was 66-80 Gy/ 6.5-8.0 weeks in the nasopharyngeal lesion, and 60-70 Gy/6-7 weeks for the neck lymph nodes. Results The overall 5-year survival rate（OS） was 66.4%, with 69.1% ,59.0% for T3,T4 lesions（ P 〈 0.05）. However, the difference between local control, disease-free survival, relapse-free survival or metastasls-free survival rate was not significant in T3, T4 lesiom. The 5-year OS was 74.0%, 66.0%, 57.6% and 29.4% in NO, N1, N2 and N3 lesions, respectively（ P 〈 0.01）. The higher the N stage, the higher relapse and distant metastasis rate. Conclusions N stage is the dominant factor influencing the effect and prognosis of patients with local-regional advanced NPC treated by conventional RT alone. T stage was only the minor correlative factor. Using stratified combined radio-chemotherapy modality for different N stages of local-regional advanced NPC may act positively and effectively on resolving the cause of treatment failure--relapse and distant metastasis.

关 键 词：鼻咽肿瘤 晚期 鼻咽肿瘤/放射疗法 预后 

分 类 号：R739.63[医药卫生—肿瘤] R735.1[医药卫生—临床医学]