【摘要】 我院1974年全年作首程放射治疗的鼻咽癌共1302例,治疗后的1、3、5和10年生存率各为89.86％、60.60％、47％和33.03％。疗程结束时鼻咽和颈淋巴肿瘤的残留率分别为10.52％和17.27％,近半数的残存肿块可自行消退,而对部份残留病灶缩野加量照射并未能改善预后;10年内鼻咽和颈淋巴复发率各为18.43％和16.12％,复发后行再程放射治疗的10年生存率（15.04％）高于不行再程放射者（仅4.9％）,（P<0.01）;下组（ⅨⅩⅪⅫ交感）颅神经受累者的5年生存率和10年生存率只有22.2％和11.1％,与颅底破坏伴上组（Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ）颅神经损害的预后相同,建议在临床分期上同属T₄;本组资料分析说明不同年龄、性别的预后并无差异,现有病理分类法未能反映预后情况,增加局部放射剂量或综合应用化疗均未能提高疗效。本文对耳后野的设置和放射性脑脊髓病也作了进一步探讨。更多还原

【Abstract】 A total number of 1302 patients with carcinoma of the nasopharynxwere treated with radiation therapy at this hospital in 1974. All patients had histologic confirmation of their disease and a follow-up of 10 years. The overall 1,3,5 and 10-year survivals were 89.86%, 60.60%, 47% and 33.03% respectively.At the end of the radiotherapy course the residual ledions acounted for 10.52% in naspharynx and 17.27% in cervical lymph node. In about one half of the cases with residual lesions, the tumor had disappeared by them-self. Additional radiation dosage on the remnant could not improve the prognosis.Recurrence rate of the nasopharyngeal lesions and the cervical lymph node was 18.43%, and 16.12% respectively after initial treatment in 10 years. The 10 years survival rate of the patients with second radiation course (15.04%) was higher than that of the patients without second course (4.9%, P<0.01). Because the 5 and 10-years survival rate of the cases with involvement of the 9,10,11,12th cranial and the sympathetic nerve (22.2% and 11.1%) was as poor as that of those with damage of the base of the skull combined with injury of the 2,3,4,5, and 6th nerves, we suggest that these two conditions should be classified as T4 in TNM classifi cation (Guangzhou 1981).There was no difference in prognosis between both sexes and in different age groups, the pathological classification could not reflected the different prognosis and increasing tumor dosage or combined with chemotherapy had not improved the prognosis. The design of the postauricular field and radiation encephalomyelic damage has been discussed in this paper.更多还原