562例鼻咽癌放疗10年结果分析  

Ten Year Results of Radiotherapy to Nasopharyngeal Carcinoma: An Analysis of 562 Patients

作　　者：胡国清[1] 郑祖安[1] 肖仁兰[1] 胡长耀[1] 

机构地区：[1]同济医科大学附属同济医院肿瘤科,武汉430030

出　　处：《同济医科大学学报》1999年第4期359-361,共3页Acta Universitatis Medicinae Tongji

摘　　要：１９７３年１月至１９８６ 年６ 月共收治行首次根治性放疗的鼻咽癌５６２ 例。全部病人随访１０年以上。全组总的１０ 年生存率３０．８％ （１７３／５６２）。Ⅰ～Ⅳ期分别为６４．３％ （９／１４）、４５．５％ （５６／１２３）、３０．４％ （７３／２４０） 和１８．９％ （３５／１８５）， Ⅰ、Ⅱ期明显高于Ⅲ、Ⅳ期 （Ｐ＜ ０．００１）。１０ 年生存率局限于鼻咽腔为３２．５％ （１５２／４６８）， 超腔２２．３％ （２１／９４） （Ｐ＜ ０．０５）。有无颅神经受损的１０ 年生存率分别为３４．４％ 和２０％ （Ｐ＜ ０．０１）。尤以前后组颅神经同时受损和颅神经受损伴颅底骨破坏者疗效最差。颈淋巴结转移情况亦与预后明显相关， 有否淋巴结转移、颈结的固定与否、单双侧、上或全颈以及锁骨上受累均有明显不同的预后，各组间的差异均有统计学意义。照射剂量对预后亦有明显的影响，原发灶剂量６０～７５Ｇｙ 组疗效明显好于其他组。主要死因是远处转移与局部复发。认为早期诊断与早期根治性放疗是提高生存率的关键， 放疗剂量以６０～７５Ｇｙ 为佳。From 1973 through 1986, 562 patients with nasopharyngeal carcinoma (NPC) were treated by radiotherapy. All have been followed up over 10 years. The overall 10 year survival rate was 30 0% (173/562). The 10 year survival rate of stages Ⅰ to Ⅳ was 64 3% (9/14), 45 5%(56/123),30 4%(73/240) and 18 9% (35/185), respectively. The 10 year survival rate was higher in patients with the tumor limited in nasopharynx than those with tumor extending out of nasopharynx ( P <0 05). The invasion of both anterior and posterior cranial nerve was the poorest. The size, region (ipsilateral of bilateral and upper or lower neck) and movability of the metastatic nodes could influence the therapeutic results of NPC. The radiation dose is adapted between 60～75Gy. Analysis showed that tumor stage, extracavitary extension, cervical node metastasis, cranial nerve involvement and dosage were the main prognostic factors.

关 键 词：鼻咽癌 放射疗法 预后 

分 类 号：R739.630.5[医药卫生—肿瘤] R730.55[医药卫生—临床医学]