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目的：研究不同照射因素与鼻咽癌（ Ｎ Ｐ Ｃ）放疗后颞叶坏死（ Ｔ Ｌ Ｎ）的相关性及不同的生物相等模式对判断预后的准确性。方法：选择 １９７６～１９８５ 年间 Ｔ１ 期 Ｎ Ｐ Ｃ 病人１ ００８ 例，采用不同分割方案进行根治性放疗。平均随访６９ 年（０１～１７５ 年），８５６ 例（８５％ ）随访 ２ 年以上。用 ４５～６ Ｍ Ｖ 光子，标准三野照射，射野包括亚临床灶和咽后间隙第一站淋巴结，照射野的上缘在前床突上 ５ｍ ｍ 。分割照射方案： Ａ，３８ Ｇｙ／次，在３９ 天中共 ４５６ Ｇｙ，１２ 次； Ｂ，３．８ Ｇｙ／次，在 ４６ 天中共５３．２ Ｇｙ，１４ 次； Ｃ，４．２ Ｇｙ／次，在 ３９ 天中共 ５０４ Ｇｙ，１２ 次； Ｄ，２．５ Ｇｙ／次，在 ４２ 天中共 ６０ Ｇｙ，２４ 次。结果：７４ 例（７３％ ）在初程放疗后中位 ６７ 年（１９～１４９ 年）出现 Ｔ Ｌ Ｎ，６８ 例有临床症状和影像学改变，５４ 例双侧损害，２０ 例单侧损害。对于 Ａ、 Ｂ、 Ｃ、 Ｄ 四种方案， Ｔ Ｌ Ｎ 在第 １０ 年实际发生率分别为４８％ 、０％ 、１８６％ 、和 ４６％ ，方案 Ｃ 明显较其它方案高（ Ｐ＜ ０．００１）。单变量分析显示，性别和年龄无统计学意义
OBJECTIVE: To study the correlation between different irradiation factors and temporal necrosis (TLN) after radiotherapy for nasopharyngeal carcinoma (NPC) and different bioequivalence models for judging the prognosis. METHODS: A total of 1 008 patients with stage T 1 N P C were selected from 1976 to 1985, and radical radiotherapy was performed using different segmentation protocols. The average follow-up period was 6. 9 years (01-175 years), and 856 cases (85%) were followed up for more than 2 years. With 4 5 6 6 M V photons, the standard three field irradiation, the injection field including the sub-clinical and post-pharyngeal space in the first station lymph node, the upper edge of the irradiation field in the front basal process 5m m. Divided irradiation: A, 38 Gy/time, total 456 Gy, 12 times in 39 days; B, 3.8 Gy/time, 53.2 Gy in total in 46 days, 14 times; C, 4. 2 Gy/times, total 50 4 Gy, 12 times in 39 days; D, 2.5 Gy/times, total 60 Gy in 24 days, 24 times. RESULTS: 74 cases (7.3%) had TL N at the median of 6 7 years (1 9 14 9 yrs) after initial radiotherapy, 68 cases had clinical symptoms and imaging changes, 54 cases were bilateral Damage, 20 cases of unilateral damage. For the four schemes of A, B, C, and D, the actual incidence rate of T L N in the 10th year was 4.8%, 0%, 18%, and 4.6%, respectively. Plan C was significantly higher than other plans. (P<0.001). Univariate analysis showed that gender and age were not statistically significant