【摘要】 目的分析鼻咽癌治疗失败的主要原因并探讨提高生存率的方法。方法１９８８年４月至１９９１年１２月，共收治鼻咽癌２６５例，其中Ⅰ期５例，Ⅱ期７３例，Ⅲ期１１３例，Ⅳ期７４例，年龄１３～７８岁。采取６０Ｃｏ及深部Ｘ线照射。原发灶剂量６０～８０Ｇｙ／６～８ＷＫｓ，颈转移灶５５～７４Ｇｙ／５～７ＷＫｓ。对Ｎ２和Ｎ３中分单放与放疗前ＤＤＰ，５－Ｆｕ诱导化疗。随机分组各５０例。结果总５年生存率３８．５％。Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为８０．０％、６１．６％、３６．３％、１６．２％。局部复发和远处转移是治疗失败的主要原因。结论早期诊治是提高生存率的关键，减少原发灶复发应以ＣＴ为准。合理设计照射野，建议将常规耳前野的后界延至外耳孔后缘１～２厘米；对超腔、累及口咽、咽旁间隙、茎突后间隙及伴颈深上淋巴结转移者尽量使用面颈联合野，放疗前诱导化疗对Ｎ２和Ｎ３病例近期疗效满意。更多还原

【Abstract】 Objective:To analyse the main cause of failure of treatment for nesopharyngeal carcinoma and study the method of raising survival rate.Methods:From April 1988 to Dec.1991,256 patients with neosopharyngeal carcinona,of them 5 patients were in stage Ⅰ,73 in stage Ⅱ,113 in stage Ⅲand 74 in stage Ⅳ,were treated in our hospital.The ages ranged from 13 to 78 years.The patients were treated with 60 Co and 180 KV Xray.The total dose to the nasopharynx was 6082Gy/68WKs and cervical 5574Gy/57WKs.They were randomized by N2 and N3 into two groups,50 patients were treated with radiotherapy alone and 50 patients plus 5Fu and DDP chemotherapy.Result:Total of 5year survival rate was 385%.StageⅠ,Ⅱ,Ⅲ and Ⅳ were 80%,616%,363% and 162%.The main cause of treatment failure was local recurrence and distant metastasis.Conclusion:The key of raising survival rate was early diagnosis and treatment.We suggested that the rear boundary of the routine preauricular field should be extended to the back fringe of external auditory canal 12 centimetres.Those who had extra cavity,invasion areas of oropharyngeal space,retrostyloid space and metastasis with lymph nodes in upper of deep neck should use preauricular and upper neck field Induction chemotherapy is used for N2 and N3 cases before radiotherapy was good for the shortterm effect.更多还原