鼻咽癌外照射随诊10年77例分析

TEN YEAR FOLLOW-UP OF 77 NASOPHARYNGEAL CARCINOMA PATIENTS AFTER RADIOTHERAPY

1976年～1981年首程根治放疗鼻咽癌77例,10年随诊率为98.7％。疗后10年生存率为41.6％。Ⅰ、Ⅱ期病例10年生存率高,并发症发生率低。Ⅲ、Ⅳ期病例的鼻咽颅底剂量以70G～80gy组为优。N_(2-3)的疗后颈残存为多发的预后差。疗后复发或远地转移发生后化疗疗效差。早期诊断,早期根治放疗是提高生存率及提高生存质量的关键。

From 1976 to 1981 , 77 nasopharyngeal carcinoma patients were treated by 8 MWX ray. AH except one have been followed over 10 years. Thirty-two patients 41. 6% survivede for more than 10 years. Age, sex and histologic type were not prognostic. Prognosis was better in patients with stage I and stage II lesions than extensive ones. T3 and T4 lesions w^ere better controlled by higher doses (70-80 Gy) than by lower doses (60-69 Gy). Higher incidence of distant metastasis was observed in those with multiple residual lymph nodes in the neck after irradiation than single residual ones for N2 and N3 lesions. The results of chemotherapy were very poor in patients with local recurrence or distant metastatis. Severe late complications occurred in 7 patients, two hy-poglossal nerve paralysis one esophageal entrance stenosis, two amenorrhea and two bilateral temporal lobe edema. These complications could be avoided by using multiple fields, cone-down technique and avoiding overlapping over the styloid process recess. In T1 and T2 cases, reducing the total dose of external irradiation and intracavitary boosts may be considered.