影响鼻咽癌放射治疗疗效的因素分析  

The Analysis of the Prognostic Factors of Nasopharyngeal Carcinoma Treated by Radiotherapy

作　　者：黄国栋[1] 邹浩元[1] 郑志坚[1] 何艳梅[1] 

机构地区：[1]广东省梅州市人民医院放疗科,514031

出　　处：《实用癌症杂志》2003年第3期290-292,共3页The Practical Journal of Cancer

摘　　要：目的　探讨影响鼻咽癌放射治疗疗效的因素。方法　回顾性总结首程放疗的 10 0 6例鼻咽癌患者的临床资料 ,均采用6 0 Co常规分割剂量照射 ,分段放疗。结果　全组总 5年生存率为 41.5 % ,10年生存率为 2 5 .7% ,Ⅰ、Ⅱ期 5、10年生存率明显高于Ⅲ、Ⅳ期 (P <0 .0 1) ,肿瘤局限鼻咽腔者 5、10年生存率明显高于肿瘤侵出鼻咽腔者 (P <0 .0 1) ,颅神经损害和 (或 )颅底骨破坏显著影响患者生存率 (P <0 .0 1) ,颈淋巴结转移也显著影响患者生存率 (P <0 .0 1) ,照射剂量对生存率有一定影响。结论　临床分期、鼻咽原发肿瘤侵出鼻咽腔、颈淋巴结转移、颅神经损害和 (或 )颅底骨破坏。Objective To analyse the prognostic factors of nasoharyngeal carcinoma treated by radiotherapy.Methods In a retrospective study,1 006 cases of nasopharyngeal carcinoma who received primary radiotherapy from 1984.5 to 1992.6 were included.All the patients underwent routine-dose of 60Co fractionated irradiation.Results The overall survival rate was 41.5% at 5 years and 25.7% at 10 years.The 5-year and 10-year Survival rates were significantly higher in stage Ⅰ and stage Ⅱ patients than in stage Ⅲ and stage Ⅳ patients(P<0.01).The survival rate was also significantly higher in tumor limited to nasopharyngeal cavity than in tumor with extension to outside nasopharygeal cavity(P<0.01).The survival rate was dramatically low in cancer with skull base destruction and/or cranial never invasive,or with cervical lymph metastases compared with locally limited cancer without any metastasis and invasion(P<0.01).And the dose of radiation also affected the survival rate.Conclusion The clinical staging,tumor localization,cervical lymph metastasis,cranial nerve invasion or skull base destruction and the dose of radiation are the main factors which may influence the radiotherapeutic effect on nasopharyngeal carcinoma.

关 键 词：鼻咽癌 放射治疗 疗效 影响因素 临床分期 颈淋巴结转移 颅神经损害 颅底骨破坏 照射剂量 

分 类 号：R739.63[医药卫生—肿瘤] R730.55[医药卫生—临床医学]