鼻咽癌咽旁间隙受侵不同照射野放射治疗的疗效分析

ANALYSIS ON THE RESULTS BETWEEN TWO RADIOTHERAPEUTIC PROTOCOLS FOR NASOPHARYNGEAL CARCINOMA PATIENTS WITH PARAPHARYNGEAL SPACE INVASION

目的 :评价鼻咽癌咽旁间隙受侵不同照射野放射治疗的疗效。方法 :收集 1993年 1月— 1995年 12月经病理确诊、CT扫描证实有咽旁侵犯的鼻咽癌 34 8例 ,按放射治疗设野不同分为面颈联合野组和耳前野组 ,对 5年生存率、局控率、无远处转移生存率和急慢性放射损伤进行分析和评价。结果 :面颈联合野组 5年生存率高于耳前野组 (P<0 .0 5 ) ,面颈联合野组 5年局控率明显高于耳前野组 (P<0 .0 1) ,咽旁后间隙受侵面颈联合野组 5年生存率高于耳前野组 (P<0 .0 5 ) ,咽旁前间隙受侵 5年生存率两组比较无明显差异 (P>0 .0 5 ) ,面颈联合野组发生放射性咽炎、口干反应明显高于耳前野组 (P<0 .0 1) ,放射性脊髓炎、放射性脑病两组比较差异无显著性 (P>0 .0 5 )。结论

Objective:To evaluate the radiotherapy effects of nasopharyngeal carcinoma with paranasopharyngeal space invasion treated by different protocols.Methods:From January 1993 to December 1995,348 cases of nasopharyngeal carcinoma with paranasopharyngeal space invasion were confirmed by pathology and by CT scaning.The patients were divided into two groups (group A with lateral faciocervical portals and group B with preauricular portals).The overall survival rate,local regional free rate,distant metastasis free rate and radioactive injury were estimated.Results:The 5 year survival rate in group A was higher than that in group B ( P <0.05).The 5 year local regional free rate in group A was higher than that in group B ( P <0.01).The 5 year survival rate in group A with retroparanaslpharyngeal space invasion was higher than in group B ( P <0.05).The 5 year survival rate in group A with preparanasopharyngeal space invasion was no different from that of group B ( P >0.05).Radiopharyngitis and dry mouth in group A was higher than that in group B ( P <0.01).Radiospinitis and radioactive brain injury in group A was no different from that of group B ( P >0.05).Conclusion:It is suggested that nasopharyngeal carcinoma patients with retroparanasopharyngeal space invasion be treated preferably by lateral faciocervical combined radiotherapy.