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目的探讨鼻咽癌茎突后间隙侵犯的临床意义。方法１９８例Ｉ～Ⅳａ期鼻咽癌住院初治患者接受根治放疗。按茎突后间隙有无侵犯分为茎后侵犯组和茎后无侵犯组。应用Ｋａｐｌａｎ－Ｍｅｉｅｒ，Ｌｏｇ－Ｒａｎｋ及卡方检验等方法对两组病人５ａ生存率、局控率和无远处转移生存率进行分析和评价。结果两组５ａ生存率分别为４６．７６％和６８．８８％（Ｐ＝０．００２７），两组无远处转移生存率分别为７１．６８％和８４．２２％（Ｐ＝０．０４６８）。结果表明茎突后间隙侵犯者生存率和局控率降低，远处转移增多。结论茎突后间隙的侵犯是影响预后的重要因素之一，在分期上将之划归Ｔ３是合理的；在鼻咽癌放射治疗设计中，鼻咽、咽旁特别是茎突后间隙、颅底、上颈淋巴结引流区应设置在同一靶区内。
Objective To investigate the clinical significance of the invasion of the posterior gap of nasopharyngeal carcinoma. Methods A total of 198 patients with stage I-IVa nasopharyngeal inpatients admitted to our hospital underwent radical radiotherapy. According to the posterior bulbar gap without invasion is divided into post-stem infiltration group and stem without invasion group. Kaplan-Meier, Log-Rank and chi-square test were used to analyze and evaluate the 5-year survival rate, local control rate and distant metastasis-free survival rate in both groups. Results The survival rates of two groups were 46.76% and 68.88% respectively (P = 0.0027), and the distant metastasis survival rates of the two groups were 71.68% and 84.22% (P = 0.0468 ). The results show that the survival rate of post-styloid approach and local control rate decreased, distant metastasis increased. Conclusion The invasion of the posterior styloid process is one of the important factors affecting the prognosis. It is reasonable to classify the posterior segment of the styloid process into T3. In the radiotherapy design of nasopharyngeal carcinoma, nasopharyngeal and parapharyngeal especially the posterior styloid process, Bottom, upper cervical lymph node drainage area should be set in the same target area.