N_0期鼻咽癌颈部可疑阳性淋巴结64Gy放疗疗效观察

The Efficacy of Cervical Suspicious Positive Lymph Nodes with 64Gy Radiotherapy in Patients with Nasopharyngeal Cancer Stage N_0

[目的]观察N0期鼻咽癌患者颈部可疑阳性淋巴结(最大横断面短径≥0.5cm但<1cm、包膜完整、无中央坏死)给予放疗剂量64Gy时的疗效,患者的不良反应及预后。[方法]66例N0期鼻咽癌患者,颈部可疑阳性淋巴结予以64Gy的放疗剂量,以MRI检查为标准,评价疗效。[结果]放疗剂量达64Gy时颈部淋巴结转移灶完全缓解62例,有效率达93.9%,放疗前后淋巴结消退情况差异有统计学意义(P<0.05)。在治疗结束时所有患者均出现Ⅰ级放射性皮炎,并在5年随访过程中无颈部淋巴结复发,无颈部皮下组织纤维化患者。[结论]64Gy的放疗剂量对鼻咽癌颈部可疑阳性淋巴结转移能很好地控制,且不良反应较轻,患者可耐受。

[Purpose] To investigate the efficacy, toxicities and prognosis of cervical suspicious positive lymph nodes（maximum cross-sectional short diameter ≥0.5cm and 1cm, encapsulated, no central necrosis） with 64Gy radiotherapy in patients with nasopharyngeal cancer stage N0. [Methods] Sixty-six cases with nasopharyngeal cancer stage N0with cervical suspicious positive lymph nodes were treated with 64Gy radiotherapy, and the efficacy was evaluated by MRI.[Results] Complete response of cervical lymph node metastases with 64Gy radiotherapy was found in 62 cases,with response rate 93.9%.There was significant difference in lymph nodes subsiding before and after radiotherapy（P〈0.05）.There was levelⅠ radiodermatitis in all patients at the end of treatment. There was no cervical lymph node recurrence and neck fibrosis in 5-year follow-up. [Conclusion] The 64Gy radiotherapy dose is suitable for the suspicious positive metastatic cervical lymph node, with less and tolerable toxicities.