85例低发区鼻咽癌放射治疗分析

Radiotherapy of nasopharyngeal carcinoma in low incidence region(an analysis on 85 cases)

目的 评价低发区鼻咽癌放射治疗疗效及影响预后的因素。方法 放疗采用常规分割剂量连续放疗 (每次DT2 0 0cGy ,每周 5次 ) ,鼻咽放疗总剂量DT40～ 80Gy ,平均 6 5 6 2Gy。颈部N0 者DT40～ 5 0Gy ,N1～ 3 者DT6 0～ 80Gy ,随访至 5年。生存率统计采用Kaplan -Meier法。 结果 85例总的 1、2、3、4、5年累积生存率分别为 75 3%、5 8 6 %、40 7%、38%、36 3%。生存率随期别降低 (P =0 0 0 2 ) ,女性较男性预后好 (P =0 0 6 )。死亡 5 2例 ,死亡原因主要为鼻咽原发灶或 (和 )颈部转移淋巴结复发或未控 (2 2例 ,占 42 3 % )及远处转移 (2 1例 ,占 40 4% )。结论 ① 85例低发区鼻咽癌总的放射治疗疗效略差。②女性病人预后相对较好。③鼻咽癌原发灶或 (和 )颈部转移淋巴结复发或 (和 )未控及远处转移均是死亡的主要原因。

Objective To evaluate the radiotherapy effects and prognostic factors of nasopharyngeal carcinoma(NPC) in low incidence region Methods The conventional fractionation radiotherapy(2Gy per day, 5 times a week) was given to 85 patients with a mean total dose of 65 62Gy(ranged from 40 to 80Gy) for the primary tumor, with 40～50Gy for No cervical lymph nodes; with 60～80Gy for N 1～3 cervical lymph nodes All patients were followed up for 5 years Survival curve was obtained by Kaplan-Meiermethod Results The overall 1、2、3、4、5 year cumulative survival rates were 75 3%、58 6%、40 7%、38%、36 3% respectively The survival rates decreased with stages(p=0 002) Prognosis was slightly better in female patients The main death causes were local recurrence or uncontrol of primary tumor(or) cervical lymph nodes(22 cases, accounted for 42 3%) and distant metastases (21 cases, accounted for 40 4%) Conclusions The radiotherapy effects of nasopharyngeal carcinoma(NPC) in low incidence region were relatively poorer than that in high low incidence region; Female patients had a slightly better prognosis in low incidence region; The local recurrence or uncontrol of primary tumor(or) cervical lymph nodes and distant metastases were the main causes of death