鼻咽癌咽旁间隙受侵面颈联合野照射疗效观察

The long term results of radiotherapy for nasopharyngeal carcinoma patients with involvement of the parapharyngeal space

目的 :评价鼻咽癌咽旁间隙受侵面颈联合野照射长期疗效。方法 :从 1991年 1月至 1993年 12月 ,经 CT诊断咽旁间隙侵犯 ,实行面颈联合野照射的鼻咽癌病人 49例 ,按临床分期分层随机抽取同时期非面颈联合野照射 49例病人为对照组。 5年局控率、生存率计算用 Kaplan- Meier法 ,L og- rank作显著性检验。计数资料用 χ2检验。结果 :面颈联合野组生存率、局控率曲线图明显高于非面颈联合野组 (P <0 .0 5 ) ;茎突后区受侵面颈联野组生存率明显高于非面颈联合野组 (P= 0 .0 35 )。两组病人急性放射性反应以及放疗后遗症未见差异 (P >0 .0 5 )。结论 :鼻咽癌咽旁间隙受侵采用面颈联合野照射能提高生存率 。

Objective:To evaluate the radiotherapy effects of nasopharyngeal carcinoma (NPC)with involvement of parapharyngeal space treated by faciocervical portals Methods:49 NPC patients with involvement of parapharyngeal space as assessed by CT scan were treated by faciocervical portals from Jan 1991 to Dec 93 (groups A) 49 NPC patinets with involvement of parapharyngeal space were treated by preauricular portals plus nose portals (group B) Diagnosis in all cases was confirmed by pathology Survival curve was obtained by Kaplan-Meier calculation and logrank test Results:5-year local recurrence rates for groups A and B were 30 6%(15/49) and 53 1 (26/49),5-year survival rates were 61 2%(32/49) and 40 8%(20/49),respectively Survival curve in group A was higher than in group B (P<0 05) Survival curve in gorup A for retrostyloid involvement was higher than in group B (P<0 05) Conclusions:The postradiation survival rate in NPC patients with para-pharyngeal involvement is improved by the use of faciocervical portals without inflicting more radiation reactions or late-damages It is suggessted that NPC patients with parapharyngeal involvement are preferably treated by faciocervical portals