晚期鼻咽癌放疗后随诊10年分析

Ten Year Follow-up of 301 Advanced Nasopharyngeal Carcinoma Patients after Radiotherapy

通过长期随诊评价晚期鼻咽癌放射治疗的效果并探讨其预后因素。方法采用单因素分析方法对随访１０年以上的３０１例Ⅲ、Ⅳ期鼻咽癌患者的性别、年龄、病理类型、分期、原发灶放疗的剂量、化疗及其对预后的影响进行研究。结果放射治疗后５、１０年生存中分别为３８．２１％和１９．９３％。失败原因以局部及区域复发为主，占６１．７％。治疗剂量与期别对预后有明显影响。结论期别早生存率高，原发灶放疗剂量以７０～８０Ｇｙ／７～９周为宜，为避免病变漏照应设面预联合野。

Objective To evaluate the effect of radiotherapy of advanced nasopharyngeal carcinoma and the prognostic factors throuth long-up. Methods From June 1972 to May 1987, 301 advanced nasopharyngeal carcinoma patients were treated by radiation. The rate of ten year follow-up was 98. 67%. Rcsults After radiotherapy 5-10-year survival rates were 38. 21% and 19. 93%, respectively.Age , sex and histologic type were not progostic, Prognosis was better in patients with stage I lesions than stage N ones. 70-80 Gy/7-9 weeks was better than lower doses on controlling primary tumors. The nasopharynx and (or) regional recurrence was the main failure reason. Conclusion Patients with earlier stage had higher survival rate. The appropriate doses of primary extemal radiotherapy were 70-80 Gy/7-9 weeks. To cover all of the lesions , upper lateral fields including the nasopharynx ,oropharynx and regional lymphnods should be used.