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我院1974年全年作首程放射治疗的鼻咽癌共1302例,治疗后的1、3、5和10年生存率各为89.86％、60.60％、47％和33.03％。疗程结束时鼻咽和颈淋巴肿瘤的残留率分别为10.52％和17.27％,近半数的残存肿块可自行消退,而对部份残留病灶缩野加量照射并未能改善预后;10年内鼻咽和颈淋巴复发率各为18.43％和16.12％,复发后行再程放射治疗的10年生存率(15.04％)高于不行再程放射者(仅4.9％),(P<0.01);下组(ⅨⅩⅪⅫ交感)颅神经受累者的5年生存率和10年生存率只有22.2％和11.1％,与颅底破坏伴上组(Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ)颅神经损害的预后相同,建议在临床分期上同属T_4;本组资料分析说明不同年龄、性别的预后并无差异,现有病理分类法未能反映预后情况,增加局部放射剂量或综合应用化疗均未能提高疗效。本文对耳后野的设置和放射性脑脊髓病也作了进一步探讨。
A total of 1,302 nasopharyngeal carcinomas for the first course of radiation therapy in our hospital were performed in 1974. The 1, 3, 5 and 10 year survival rates after treatment were 89.86%, 60.60%, 47% and 33.03%, respectively. At the end of the treatment period, the residual rates of nasopharyngeal and cervical lymphomas were 10.52% and 17.27%, respectively. Nearly half of the residual tumors were self-resolved. However, the irradiation of partial residual lesions with reduced field radiation did not improve the prognosis; within 10 years, the nasopharyngeal The recurrence rates of cervical lymph node and neck lymphoma were 18.43% and 16.12%, respectively. The 10-year survival rate (15.04%) of recurrence radiotherapy after relapse was higher than that of non-recurrence radiation (only 4.9%) (P<0.01). (IXXXIXII sympathetic) The 5-year survival rate and 10-year survival rate of cranial nerve involvement were only 22.2% and 11.1%, which was the same as the prognosis of skull base destruction with cranial nerve damage in the group (II, III, IV, V, VI). It is suggested that T_4 belong to the same clinical stage. The analysis of the data in this group shows that there is no difference in the prognosis of different ages and genders. The current pathological classification fails to reflect the prognosis. Increased local radiation dose or combined application of chemotherapy has not improved the efficacy. This article also discusses the setting of post-auricularia and radiation-induced myelopathy.