Carcinoma of the nasopharynx: An analysis of 91 cases and a comparison of differing treatment approaches
Carcinoma of the nasopharynx: An analysis of 91 cases and a comparison of differing treatment approaches
复制标题
鼻咽癌91例分析及不同治疗方法比较
作者：
M. Rahima;E. Rakowsky;J. Barzilay;J. So
对1970年至1982年在我科就诊的91例鼻咽部恶性上皮肿瘤患者进行了评价。5年和10年精算生存率分别为62.0%和42.0%。1970年至1979年的患者接受了原发部位和上颈部的放射治疗，下颈部仅在巨大疾病的情况下接受放射治疗。1980年至1982年接受治疗的患者接受了选择性全颈放疗，以及放疗结束后6至12个月的辅助化疗（包括环磷酰胺，甲氨蝶呤和5-氟尿嘧啶或博莱霉素）。3年精算生存率（61.4% vs 83.3%）和无病生存率（49.7% vs 77.0%）的比较显示，接受联合治疗的患者的结果显著改善（P < 0.05）。此外，18个月时，联合治疗组出现的远处转移明显较少（P < 0.05）。一项回顾性分析比较了接受全颈放疗和辅助化疗的患者与仅接受全颈放疗的患者，结果显示接受辅助化疗的未分化癌（包括淋巴上皮瘤）患者的生存率（P < 0.02）和无病生存率（P < 0.05）显著提高。
Ninety‐one patients with malignant epithelial tumors of the nasopharynx seen in our department from 1970 to 1982 were evaluated. The 5‐ and 10‐year actuarial survival rates were 62.0% and 42.0%, respectively. Patients Seen from 1970 to 1979 were treated by radiotherapy to the primary site and upper neck, the lower neck being irradiated only in instances of massive disease. Those treated from 1980 to 1982 received elective irradiation of the whole neck, as well as adjuvant chemotherapy (consisting of cyclophosphamide, methotrexate, and either 5‐fluorouracil or bleomycin) for 6 to 12 months after completion of radiotherapy. Comparison of 3‐year actuarial survival (61.4% versus 83.3%) and disease‐free survival (49.7 versus 77.0%) rates show significantly improved results (P < 0.05) for those receiving combined therapy. In addition, significantly fewer (P < 0.05) distant metastases appeared in the combined therapy group at 18 months. A retrospective analysis comparing those patients who received full‐neck irradiation and adjuvant chemotherapy with those who received full‐neck irradiation alone showed a significantly improved survival (P < 0.02) and disease‐free survival (P < 0.05) for those patients with undifferentiated carcinomas, including lymphoepitheliomas, who received adjuvant chemotherapy.