[Radiotherapy of nasopharyngeal carcinoma--analysis of 1379 patients].
[Radiotherapy of nasopharyngeal carcinoma--analysis of 1379 patients].
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鼻咽癌放射治疗1379例分析
DOI：
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发表时间：
1988
期刊：
影响因子：
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通讯作者：
X. Gu
中科院分区：
文献类型：
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作者：
D. Qin;Y. H. Hu;J. Yan;G. Xu;W. Cai;X. Wu;D. Cao;X. Gu
本文介绍了我院自1958年3月至1978年12月收治的1379例鼻咽癌患者，其中I、II期病变占22％，III、IV期病变占78％。 1960 年之前使用 220 KV X 射线，1961 年至 1978 年期间主要使用 60Co。总体 5 年生存率为 41.4% (571/1379)。年轻人和女性患者效果更好。按病理类型分，低分化鳞癌5年生存率为45.1%，腺癌5年生存率为13%；按临床分期，I期病变占85.7%，II期占59.5%，III、IV期占45.8%和29.2%。按治疗时期分，60年代为31.3%，70年代为48.6%；根据肿瘤原发灶剂量，40-49 Gy 为 48.2%，60-69 Gy 为 55.6%，90 Gy 及以上为 67.3%；根据颈部是否接受预防性放射治疗，前者为 53.8%，后者为 23%。这意味着无论是否存在颈部淋巴结转移，颈部的预防性放射治疗都是必要的。对于70Gy仍有肿瘤残留者，可采用锥降技术将总剂量提高至90Gy以上，或在原发病灶基本消失时再加20Gy。常见的并发症有放射性脊髓炎、牙关紧闭和中耳炎。由于某些患者放疗后5年病灶仍会复发，作者认为鼻咽癌患者至少应随访10年。
This paper presents 1379 patients with nasopharyngeal carcinoma treated in our hospital from March 1958 to December 1978. The stage I and II lesions comprised 22% and stage III and IV lesions, 78%. 220 KV X-ray was used before 1960 and 60Co was predominant from 1961 through 1978. The overall 5 year survival rate was 41.4% (571/1379). Young adults and female patients gave better results. The 5 year survival rate was, according to pathological type, 45.1% for poorly differentiated squamous cell carcinoma and 13% for adenocarcinoma; according to clinical stage, 85.7% for stage I lesion, 59.5% for stage II, 45.8% and 29.2% for stages III and IV; according to period of treatment, 31.3% in the sixties and 48.6% in the seventies; according to tumor dose at the primary focus, 48.2% for 40-49 Gy, 55.6% for 60-69 Gy and 67.3% for 90 Gy or more; according to with or without prophylactic radiation in the neck region, 53.8% for the former and 23% for the latter. It implies that prophylactic radiation of the neck is necessary regardless of the presence of cervical lymph node metastasis or not. For those who had residual tumor at 70 Gy, the total dose may be boosted to more than 90 Gy with the cone down technic or the dose, at which the primary lesion disappears grossly, is added with 20 Gy. The common complications are radiation myelitis, trismus and otitis media. As in certain patients, the lesion would still recur 5 years after radiotherapy, the authors believe that the nasopharyngeal cancer patients should be followed for ten years at least.