【摘要】 目的:分析鼻咽未分化癌的治疗方法治疗效果。方法:鼻咽未分化癌46例,其中I期1例,II期5例,III期25例,IV期15例。37例根治性放疗中,19例行放疗+化疗(9例联合用药,10例单药化疗),18例行单纯放疗;9例因已出现远处转移或治疗中自行放弃行姑息性放疗。采用Kaplan-Meier方法进行生存率分析,显著性差异采用Log-rank检验。结果:①全组1、3、5、10年生存率分别为80.9%、47.6%、35.7%、28.6%,中位生存期为32个月。按分期的生存率曲线差异有显著性(P=0.0005)。②根治性放疗组中,局部控制率为75.7%(28/37例),局部病灶控制与否对生存曲线的影响有显著性差异(P=0.0417)。根治性放疗+联合化疗与单纯根治性放疗的1、3、5、10年生存率分别为100%、75%、75%、62.5%和75%、50%、31.3%、25%,鼻咽未分化癌根治性放疗+联合化疗疗效好于单纯根治性放疗(P=0.0811)。③姑息治疗的生存情况是1年生存率为55.5%(5/9例),无2年以上生存者。结论:①鼻咽未分化癌进展快,发生远处转移早,生存率差。②放射治疗敏感,是主要的有效方法;未发生远处转移的鼻咽未分化癌根治性放疗+联合化疗可提高生存率。更多还原

【Abstract】 Objective:To evaluate the therapeutic efficacy of combination of chemotherapy in 46 undifferentiated nasopharyngeal carcinoma.Mothods: Forty-six cases of undifferentiated nasopharyngeal carcinoma were treated,1 case had stage I lesion,5 had stage II lesions,25 had stage III lesions and 15 had stage IV lesions.In 37 patients receiving radical irradiation,18 were treated by only radiotherapy and 19 cases by radiotherapy plus chemotherapy(10 cases cisplatin-based combination,9 cases only cisplatin).Nine patients received palliative irradiation due to distant metastasis before treatment or abandoning by themselves.Kaplan-Meier method was used in the survival analysis and the Logrank test to inspect into possible differences.Results:① The survival rate of the whole group in 1-,3-,5-and 10-year were 80.9%,47.6%,35.7%,28.6%,respectively,Median survival time was 32 months.② The 1-,3-,5-and 10-year survival rate for radical irradiation plus combination chemotherapy or unique radical radiotherapy were 100%,75%,75%,62.5% and 75%,50%,31.3%,25% respectively(P=0.0811).The local control rate of the tumor was 75.7%,it did affect survival rate(P=0.0417).③ The 1 year survival rate for palliative irradiation was 55.5%, and there was no case of 2-year survival.Conclusion:① Undifferentiated nasopharyngeal carcinoma is quickly matastatic with rather poor prognosis.② The radiotherapy is still one of major and efficient treatments for undifferentiated nasopharyngeal carcinoma,it can raise the local control rate of tumor and improve survival rate with cisplatin-based combination chemotherapy.更多还原