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目的 回顾性分析比较单纯根治性放射治疗与放射治疗联合化疗治疗鼻咽癌的远期疗效并分析其它相关因素对其预后的影响。方法 从 1988年 1月至 1996年 3月共住院收治 895例鼻咽癌。根据不同的治疗方法分为两组 ,单纯根治性放射治疗组 (单放组 ) 768例 ,放疗方式包括常规、腔内及超分割放疗 ,采用常规设野 ,照射剂量为 68～ 79.6Gy ;根治性放射治疗同期联合化疗组 (联合组 ) 12 7例 ,放疗方法同单放组 ,同期化疗 2～ 3个周期 (方案为DDP +5 Fu或DDP +5 Fu +BLM )。结果 本组病例总的 5年生存率为 5 0 .74% ,其中单放组和联合组的 5年生存率分别为 48.46%和5 6.80 % (P <0 .0 0 0 1)。用多因素逐步回归分析 ,N分期对生存率的影响最大 (P <0 .0 0 0 1) ;T分期对生存率亦有影响 (P<0 .0 5 ) ;加用化疗能提高生存率 (P <0 .0 0 1)。结论 提示采用根治性放射治疗同期联合化疗对于鼻咽癌的远期疗效似有提高的趋势 ,特别是对于N2、N3的病例。
Objective To retrospectively analyze and compare the long-term effects of simple radical radiotherapy with radiotherapy combined with chemotherapy in the treatment of nasopharyngeal carcinoma and analyze the influence of other related factors on the prognosis. Methods From January 1988 to March 1996 were hospitalized 895 cases of nasopharyngeal carcinoma. According to different treatment methods, the patients were divided into two groups, 768 cases of radiotherapy alone group (radiotherapy alone group). The radiotherapy methods included routine, intracavitary and radiofrequency radiotherapy. The radiotherapy dose was 68-79.6Gy In the same period, 12 7 cases were treated with combination radiotherapy (combination group). The radiotherapy method was the same as that of the radiotherapy group with 2 to 3 cycles of chemotherapy (with DDP +5 Fu or DDP +5 Fu + BLM). Results The overall 5-year survival rate of this group was 50.74%. The 5-year survival rates were 48.46% and 56.80% in the radiotherapy alone group and the combined therapy group respectively (P0.001). With multi-factor stepwise regression analysis, N stage had the most significant impact on survival rate (P <0.001); T stage also had an impact on survival rate (P <0.05); chemotherapy plus chemotherapy increased survival rate (P <0. 0 0 1). Conclusions suggest that the use of radical radiotherapy concurrent chemotherapy with nasopharyngeal carcinoma seems to improve the long-term efficacy, especially for the cases of N2, N3.