摘要
鼻咽癌除易于广泛局部浸润外,亦有较高的血源性播散及早期淋巴结转移发生率。 以前何氏研究显示淋巴结阴性者不予预防照射多数病例无转移,既使后发生淋巴结受累,治疗后不影响最终生存率。因此,除预计患者不能按期观察或有特殊较差预后外,我院对淋巴结阴性的鼻咽癌不做预防性照射。本文回顾1981年至1985年治疗病例,以探讨治疗失败的原因。
It is a retrospective analysis of 2523 available patients suffering from nasopharyngeal squamous cell carcinoma who were treated during 1981-1985. 91% (2294/2523) of patients recie\ ed total course of high-energy irradiation. Medium equivalent dose in nasopharyngeal region was 65 Gy and 53 Gy to the cervical region involved^ 75% (499/666) patients without lymph node involved did not recieve regional irradiation. The actuarial 5-year survival rate was 57%. Recurrence free rate was 42%. The actuarial 5-year local and regional relapse free rates and distant metastasis free rates were 70%. 69% and 65%, respectively. The distant metastasis rate was related to N and T (N0 15%, N1 25%, N2 35%, N3 54%; T1 27%, T2 31%, T3 36%). 28% of the patients had regional failure (11% were residual and 17% were recurrence). After cervical irradiation the regional relapse rate in positive and negative node patients were 12% (215/1755) and n% (19/167) respectively, whereas 38% in those negative node patients who did not recieve elective node irradiation (ENI). For those patients without ENI, therapeutic irradiation resulted in 92% node remission. Although regional salvage treatment was quite successful,the distant dissemination rate was higher in these patients than in patients without regional relapse (20% vs 5%). Because elective node irradiation can effectively reduce local recurrence and does not result in severe complications, it should be applied to all patients with negative cervical node.
出处
《中华放射肿瘤学杂志》
CSCD
1991年第4期11-13,共3页
Chinese Journal of Radiation Oncology
