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目的 评价低发区鼻咽癌放射治疗疗效及影响预后的因素。方法 放疗采用常规分割剂量连续放疗 (每次DT2 0 0cGy ,每周 5次 ) ,鼻咽放疗总剂量DT40～ 80Gy ,平均 6 5 6 2Gy。颈部N0 者DT40～ 5 0Gy ,N1～ 3 者DT6 0～ 80Gy ,随访至 5年。生存率统计采用Kaplan -Meier法。 结果 85例总的 1、2、3、4、5年累积生存率分别为 75 3%、5 8 6 %、40 7%、38%、36 3%。生存率随期别降低 (P =0 0 0 2 ) ,女性较男性预后好 (P =0 0 6 )。死亡 5 2例 ,死亡原因主要为鼻咽原发灶或 (和 )颈部转移淋巴结复发或未控 (2 2例 ,占 42 3 % )及远处转移 (2 1例 ,占 40 4% )。结论 ① 85例低发区鼻咽癌总的放射治疗疗效略差。②女性病人预后相对较好。③鼻咽癌原发灶或 (和 )颈部转移淋巴结复发或 (和 )未控及远处转移均是死亡的主要原因。
Objective To evaluate the efficacy of radiotherapy for nasopharyngeal carcinoma in low incidence area and its prognostic factors. Methods Radiotherapy was carried out by conventional radiotherapy (DT2 0 cGy, 5 times per week). The total dose of nasopharyngeal radiotherapy was DT40 ~ 80 Gy, averaging 6 5 6 2Gy. Neck N0 DT40 ~ 5 0Gy, N1 ~ 3 DT6 0 ~ 80Gy, followed up to 5 years. Survival statistics using Kaplan-Meier method. Results The cumulative survival rates of 85 cases at 1, 2, 3, 4, 5 years were 75 3%, 586%, 40 7%, 38% and 36 3%, respectively. Survival rate decreased with the period (P = 0 0 0 2), women than men, good prognosis (P = 0 0 6). Deaths occurred in 52 cases. The main causes of death were recurrence or non-control (22 cases, 42.3%) and distant metastases (21 cases, 40.4%) in primary nasopharyngeal or / and cervical lymph nodes . Conclusion ① 85 cases of low incidence of nasopharyngeal carcinoma total radiation therapy slightly worse. ② The prognosis of female patients is relatively good. ③ nasopharyngeal carcinoma or (and) cervical lymph node recurrence or (and) uncontrolled and distant metastasis are the main cause of death.