[目的]探讨鼻咽癌综合治疗策略。[方法]回顾性分析无远处转移初治鼻咽癌749例,按’92分期标准对所有病例重新分期。根据患者不同T、N组合的死亡风险比及生存情况,将病人分为5组:早期N0组(T1～2N0)、早期N1组(T1～2N1)、局部晚期组(T3～4N0～1)、区域晚期组(T1～2N2～3)、局部区域晚期组(T3～4N2～3)。比较各组的5年总生存率、5年累积局部区域复发率、远处转移率和死亡风险比等。[结果]早期N1组较早期N0组,5年总生存率明显下降(84.7%vs95.4%,P=0.005),5年远处转移率明显升高(10.8%vs0.1%,P=0.0004),死亡风险比分别为1和3.8;局部晚期组与区域晚期组比较,5年总生存率、累积远处转移率及累积局部区域复发率差异均无统计学意义穴61.4%vs63.9%、20.3%vs24.6%、19.1%vs15.6%,P>0.05雪,死亡风险比在同一层次,分别为10.1及10.0;局部区域晚期组5年总生存率仅48.2%,死亡风险比高达16.4。[结论]鼻咽癌的治疗应根据患者具体的T、N分期组合进行分层分析治疗,T1～2N0预后好,可予单纯放疗;T1～2N1病人应考虑放疗联合化疗的综合治疗,T3～4和/或N2～3患者有较高的复发及转移率,应增加放化疗综合治疗的强度。 [Objective] To explore the comprehensive treatment strategy of nasopharyngeal carcinoma. [Methods] 749 nasopharyngeal carcinomas without distant metastasis were retrospectively analyzed. All cases were re-staged according to the ’92 staging criteria. The patients were divided into 5 groups according to the risk ratio of death and survival of patients with different T and N combinations: early N0 group (T1 ~ 2N0), early N1 group (T1 ~ 2N1), locally advanced group (T3 ~ 4N0 ~ 1) , Regional advanced group (T1 ~ 2N2 ~ 3), partial regional advanced group (T3 ~ 4N2 ~ 3). The 5-year overall survival rate, 5-year cumulative local regional recurrence rate, distant metastasis rate and death risk ratio were compared among the groups. [Results] The 5-year overall survival rate of the early N1 group was significantly lower than that of the N0 group (84.7% vs 95.4%, P = 0.005), and the distant metastasis rate was significantly higher at 5 years (10.8% vs 0.1%, P = 0.0004), and the risk of death was 1 and 3.8, respectively. There was no significant difference in 5-year overall survival rate, cumulative distant metastasis rate and cumulative regional recurrence between the local advanced group and the advanced regional group (P <0.01) 61.4% vs63.9 %, 20.3% vs24.6%, 19.1% vs15.6%, P> 0.05 snow, the risk of death at the same level were 10.1 and 10.0, respectively. The 5-year overall survival rate was only 48.2% Up to 16.4. [Conclusion] The treatment of nasopharyngeal carcinoma should be stratified and analyzed according to the specific T and N staging of the patients. The prognosis of T1 ~ 2N0 is good and can be treated by radiotherapy alone. The patients with T1 ~ 2N1 should consider the combination of radiotherapy and chemotherapy, 4 and / or N2 ~ 3 patients have a higher recurrence and metastasis rate, should increase the intensity of chemotherapy and radiotherapy.