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目的：通过分析鼻咽癌咽旁侵犯对放射治疗预后的影响，为合理的临床分期提供依据。方法：收集１９８４年１０月至１９８９年９月经我院病理确诊、ＣＴ扫描证实有咽旁侵犯的１２０例，全部病例随访５年以上。全部病例以常规分段放射治疗，鼻咽原发灶设两耳前野为主，部分辅以鼻前野。鼻咽肿瘤总剂量６８～７８Ｇｙ，照射３４～３９次／７２～８５天。颈部根治性肿瘤总剂量６０～６８Ｇｙ，照射３０～３４次／７２～７６天；预防剂量为５０Ｇｙ。结果：茎突前区和茎突后区受侵者五年生存率分别为６６．１３％和４４．８３％；２年内鼻咽复发率分别为１９．３５％和４４．８３％。茎突前区咽旁侵犯同时伴有颅底破坏、颅神经损害和口咽侵犯者５年生存率分别为６．４５％；６．４５％和１１．４９％，而茎突后区分别为１８．９７％；２５．８６％和３６．２１％。结论：咽旁茎突前区侵犯的５年生存率较茎突后区为高。但茎突前区无论在局部复发、伴颅底破坏、颅神经损害和口咽侵犯均较茎突后区为低，故在临床分期上后者属较晚期。
Objective: To analyze the influence of parapharyngeal invasion of nasopharyngeal carcinoma on the prognosis of radiation therapy and provide the basis for reasonable clinical staging. Methods: Totally 120 cases of parapharyngeal invasion confirmed by CT scan from October 1984 to September 1989 were collected. All cases were followed up for more than 5 years. All cases with conventional sub-radiation therapy, nasopharyngeal foci located in the two ears before the main field, part of the nose supplemented by the former field. The total dose of nasopharyngeal tumor 68 ~ 78Gy, irradiation 34 ~ 39 times / 72 ~ 85 days. Radical neck cancer total dose of 60 ~ 68Gy, irradiation 30 ~ 34 times / 72 ~ 76 days; prevention dose of 50Gy. Results: The five-year survival rate of the invaders in the anterior and posterior styloid processes were 66.13% and 44.83% respectively. The nasopharyngeal recurrence rates in two years were 19.35% and 44.83%, respectively. The 5-year survival rates of cranial nerve damage and oropharyngeal invasion were 6.45%, 6.45% and 11.49%, respectively, while the posterior styloid processes were 18.97%; 25.86% and 36.21%. Conclusion: The 5-year survival rate of the parapharyngeal styloid process is higher than that in the posterior styloid process. However, regardless of the styloid process in the local recurrence of the front, with skull base damage, cranial nerve damage and oropharyngeal invasion are inferior to the posterior segment of the styloid process, so the latter is the clinical stage of the latter.