Carcinoma of the nasopharynx. Eighteen years' experience with megavoltage radiation therapy
Carcinoma of the nasopharynx. Eighteen years' experience with megavoltage radiation therapy
复制标题
鼻咽癌。
作者：
R. Hoppe;D. Goffinet;M. Bagshaw
从1956年至1973年，82例鼻咽癌患者在斯坦福大学接受了大剂量兆伏放射治疗。5年和10年时的精算无病（NED）生存率分别为62%和56%。T1、T2和T3病变患者的5年NED生存率分别为76%、68%和55%。没有T4患者被挽救，但10名出现颅神经功能障碍的患者中有2名是长期存活者。淋巴结受累程度也有预后意义。当给予至少6500拉德的剂量时，在所有情况下均成功控制了受累淋巴结。32例患者初始治疗失败。在24例（75%）中，这发生在18个月内。13例头颈部初次复发的患者接受了再次治疗，3例仍然存活。再治疗后的生存期为2个月至10年，中位生存期为16个月。虽然近三分之一（6/17）的局部复发患者有初始T1或T2病变，但在过去7年中，这些早期阶段的患者没有失败。这可能是由于使用了更大的治疗野。同样，如果原发部位得到控制，颈部的预防性照射总是能成功预防淋巴结疾病。
From 1956 through 1973, 82 patients with carcinoma of the nasopharynx received high dose megavoltage radiation therapy at Stanford University. The actuarial disease‐free (NED) survival was 62% at 5 years and 56% at 10 years. The NED survivals at 5 years for patients with T1, T2, and T3 lesions were 76%, 68%, and 55%, respectively. No T4 patients were salvaged, but two of 10 patients who presented with cranial nerve dysfunction were long‐term survivors. The degree of nodal involvement also had prognostic significance. Involved lymph nodes were successfully controlled in all instances when doses of at least 6500 rads were given. Initial treatment failed in 32 patients. In 24 (75%) this occurred within 18 months. Thirteen patients with initial recurrences in head and neck sites were retreated and three remain alive. Survival after retreatment ranged from 2 months to 10 years, with a median of 16 months. Although nearly one‐third (6/17) of the patients with local recurrences had initial T1 or T2 lesions, there have been no failures in patients treated for these early stages in the last 7 years. This may be attributed to the use of larger treatment fields. Likewise, prophylactic irradiation of the neck was always successful in preventing nodal disease if the primary site was controlled.