51例老年鼻咽癌临床分析

CLINICAL ANALYSIS OF 51 NASOPHARYNGEAL CARCINOMA CASES OF THE AGED

目的 探讨老年鼻咽癌的临床特征及诊治方法，提高对其的认识和重视以及对老年鼻咽癌的诊治水平。 方法 对 1990年至 1998年间收治的 51例老年鼻咽癌患者临床资料进行分析总结。 结果 本组中Ⅰ～Ⅱ期共 27例，其 5年生存率为 91.7％，Ⅲ期为 21例， 5年生存率为 38.9％。而Ⅳ期 3例，均在 3年内死亡。 结论 老年鼻咽癌的早期诊断以倾听主诉和仔细的体格检查为主，辅助以影象学（ CT、 MRI）及血清学的检查。老年鼻咽癌患者的治疗方法以放疗为首选，对于Ⅲ、Ⅳ期患者，不论颈淋巴结有无转移均应加化疗，以减少远处转移率。对于身体条件较好的患者应尽量完成预定的联合治疗计划，加强治疗后的定期随访，以期提高生存率。而对高龄的、伴有多种夹杂症的患者，辅助化疗要取慎重态度。

Objective The clinical features,diagnosis and treatment of NPC among the aged was investigated to deepen the understanding and to increase the diagnosing and managing level. Methods 51 NPC elderly cases with a mean age of 67.4 years old between 1990 and 1998 were analyzed and summarized. Results Among the 27 stageⅠ～Ⅱ cases,the 5－ year survival rate was 91.7％ ;among the 21 stageⅢ cases,it was 38.9％ .All stageⅣ patients died with in 3 years. Conclusions Early diagnosis of NPC among the aged depends mainly on inquiring the detailed history,careful physical examination combined with CT and MRI scan,and serologic test.Radiation is the treatment of choice for NPC.Whatever there are cervical metastatic lymph nodes or not,chemotherapy is necessary to stageⅢ orⅣ cases to reduce metastasis.Scheduled joint therapeutic plan should be tried to carry out fully for patients with good condition.Periodic follow－ up should be carried out so as to improve survival rate.Auxiliary chemotherapy can only be used after careful consideration in aged patients who have a variety of complications.