鼻咽癌骨转移(附136例临床分析)

The skeletal metastasis in nasopharyngeal carcinoma(NPC): clinical analysis of 136 cases

目的 探讨鼻咽癌骨转移临床特点 ,寻找有效防治措施。方法 回顾性调查 13 6例鼻咽癌骨转移临床状况及诊治疗效。结果 鼻咽癌骨转移 90 %发生于治疗后 2年内 (或 88.7%发生于颈淋巴结转移后 3年内 )。常见转移部位有脊柱 (41.3 % )、骨性胸廓 (2 8% )、盆骨 (18.2 % )、四肢长骨 (12 .5 % )及颅骨等。同侧颈淋巴结转移 40 %骨转移在同侧 ,双侧颈淋巴结转移约 2 0 %有双侧骨转移。治疗采用放疗或放疗加化疗 ,CR分别为 64 .5 %及 5 3 .3 %。结论 鼻咽癌为亲骨转移性肿瘤 ,骨转移侧别似与颈淋巴结转移侧别有关。骨转移后采用放疗或放、化疗综合治疗为宜。

Objective To study the clinical characteristics of NPC with skeletal metastasis and to find an effective way for its prevention and treatment.Methods 136 cases of NPC with skeletal metastasis were reviewed for their clinical status and therapeutic effect.Results 90% of the cases with skeletal metastasis occurred in two years after treatment(or 88.7% of the cases with skeletal metastasis occurred in three years after cervical lymph node metastasis).Skeletal metastasis often occurred at the vertebra(41.3%),the skeletal thorax(28%),pelvis (18.2%),long bones of limbs (12.5%),skull(4.5%),etc.Among patients with unilateral cervical lymph node metastasis unilateral skeletal metastasis occurred in 40% of them.Among patients with bilateral cervical lymph node metastasis,bilateral skeletal metastasis occurred in 20% of them.They were treated by radiotherapy or radiotherapy plus chemotherapy.The rates of complete remission (CR) were 64.5% and 53.3% respectively.Conclusions NPC metastasis tends to occur in bones.The side(or sides)of its skeletal metastasis is (are)likely to be related to the side (or sides)of its lymph node involvement.It is recommended that radiotherapy or radiotherapy plus chemotherapy be implied if skeletal metastasis occurred.