鼻咽癌临床分期新建议(Ⅰ)

A NEW PROPOSAL FOR THE CLINICAL STAGE OF NASOPHARYNGEAL CARCINOMA

对1985年放射治疗1422例鼻咽癌进行分析,由于CT扫描能发现更多鼻咽外侵犯而使T1期从62.27％下降到9.43％,T3+T4期则由26.41％上升至67.93％。特别指出旁咽间隙茎突后区受累比茎前区更严重而放疗设计上困难较大,应属T3;转移淋巴结大小与预后密切相关,提出以5cm和8cm划分N分期更符合临床过程;远转移比局部晚期的预后更差,应区别为Ⅳb和Ⅳa期。本分期法更能体现分期在决定放射治疗方案、指导治疗设计和评估预后的重要作用。

Clinical staging of 1 422 patients with nasopharyngeal carcinoma (NPC) treated from Jan. to Dec. 1985 in this hospital was analysed. The results showed that in primary lesion (T) stage, because more extranasopharyngeal extension were displayed by CT scan. T1 decreased from 62.27% to 9.43%,T3 and T4 increased from 26.41% to 67.93%. Data also demonstrated that patients with involved retrostyloid region had more serious clinical course and should be classified in TS; there existed close relationship between the prognosis and the size of the metastatic lymphnode according to the results of 2-year survival rate. It is reasonable to classify the N staging by the size of 5 cm and 8 cm in diameter of the lymphnode; patients with distant metastasis had more bad result than those with local advanced T, or N stage and should be differentiated in stage Ⅳb and Ⅳa respectively. The staging suggested in this paper plays an important role in guiding the radiotherapy planning and evaluating the prognosis.