【摘要】 通过对1985年放射治疗1422例鼻咽癌临床表现、CT扫描及预后的分析,强调了现代影像学（CT、MRI）在鼻咽癌临床分期上的重要作用,由于综合分析CT扫描后能发现更多鼻咽外侵犯使T_i期从62.27％下降到9.43％,而T₃+T₄期则由26.41％上升到67.93％;提出以区别鼻咽的邻近超腔或远隔超腔、放射治疗设计的难度和治疗后的生存率为原则去划分原发灶的T分期,特别指出咽旁间隙茎突后区受累比茎突前区更严重而应属T₃;无论颅底或颅神经的单项或多项侵犯,其预后相似而应同属T₄;转移淋巴结大小与预后密切相关,并提出以5cm和7cm划分N分期更合理;远处转移比局部晚期的预后更差,应区别为Ⅳb和Ⅳa期。比较了现有分期方案后,作者认为本分期法更能体现分期在决定治疗方案,指导放疗设计和评估预后的重要作用。更多还原

【Abstract】 Clinical staging classiffication of 1422 patients with nasopharyngeal carcinoma (NPC) treated from Jan. to Dec. 1985 in this hospital were analysied according to the clinical findings, CT scan and prognosis. The results showed that in primary lesion(T) stage, T1 decreased from 62.27 to 9.43% , T3 and T4 increased from 26.41%to 67.93%be-cause more extrahasopharyngeal extension were displayed by CT scan. Authors emphasized the important value of CT scan in T staging of NPC and suggested that the adjacent or distant extranasopharyngeal extension , difficulty in radiotherapy planning and the prognosis after treatment would be the principles for T staging; Data also demonstrated that patient with retrostyloid region involved had more ser-ious clinical course and should be classified in T3 ; The survival rate were very similar in patients whether with bone erosin of the base of the skull injury of the cranial nervers or combining with these two involvements, their 2- year survival rate was about 50%. So that pati)ent with anyone of involvement of these structures should be classified in T4. There was closely relationship between the prognosis and the size of the metastatic lymphnode according to the results of 2-year survival rate and the rate of distant metastasis, it is reasondadle to classify the N staging by the size of 5cm and 7cm in diameter of the lymphnode; Patient with distant metastasis had more bad result than those with local advanced T or N stage and should be differentiated in stage IVb and IVa respeactively.By making comparison with several staging systems in common use we found that the staging classif-ication suggested in this paper is of more important role in guiding the radiotherapy planning and the evaluating the prognosis.更多还原