145例鼻咽癌局部复发再放疗长期生存分析

LONG TERM SURVIVAL RESULTS OF RE-IRRADIATION FOR 145 RECURRENT NASOPHARYNGEAL CARCINOMA PATIENTS

本文分析145例鼻咽癌根治放疗后复发病人有关复发时间、部位、次数及再放疗剂量对生存的影响。全组10年生存率9．7％。复发再放疗后5年生存率12．4％。10年生存率以首次复发在根治放疗3年后以及单纯颈淋巴结复发的病人较高（分别为P＜0．025和P＜0．05）本组多次复发病人中同一部位（鼻咽或颈淋巴结）再次复发比例较高。我们认为必须强调首次根治放疗重要性，鼻咽复发再放疗剂量以60-70Gy为宜。＞70Gy生存率无改善，但治疗并发症增加。

The influence of recurrent time, location, frequency as well as dose of re - irradiation to survival for 145 cases with recurrent nasopharyngeal cancer after first ridical irradiation was analyzed. All 10 - year survival rate and 5 - year survival rate after re - irradiation were 9. 7 % and 12. 4 % respectively. In the patientswith recurrence occured more than 3 - year after first radical irradiation, 10 - year survival rate was higher than that of other groups (P< 0. 025 ). In the patients with recrrence occured only in the cervical lymph node, the 10 - year survival rate was higherthan that with recurrence in nasopharyngeal (P< 0. 05). There was an higher rate ofrepeated recurrence of the same place in this series. We believe that it is necessary toemphasize the importance of the first radical irradiation and that optional re - irradiation dose for the nasopharyngeal recurrence is 60 - 70Gy, and the one more than 70 Gyis liable to imerease the complication without improvement of the survival.