Jakob M, Manz M, Herberhold S, Schröck A, Gerstner A O H, Schüller H, Eichhorn K W G
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde/Chirurgie, Uniklinik Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
HNO. 2012 Dec;60(12):1075-81. doi: 10.1007/s00106-012-2633-8.
Nasopharyngeal carcinoma (NPC) is a rare tumor entity in Germany in contrast to endemic countries in Asia or Africa. This retrospective study investigated patient characteristics and prognostic factors with respect to different NPC treatment strategies.
A total of 63 NPC patients treated during the period 1990-2009 at the University Hospital Bonn, Germany, were included.
The median age of the patients was 56.4 years, the male:female ratio was 3.2:1, 23.8% were in Union Internationale Contre le Cancer (UICC) stage I/II and 76.2% were in stage III/IV. Most of the carcinomas were WHO type III (57.1%), followed by World Health Organization (WHO) type II (33.3%) and at last WHO type I (9.6%). The 5-year overall survival rate after concomitant chemoradiotherapy (RCT) was 75% and after radiotherapy (RT) 60%. The mortality rate increased by 3.5 times with each increase in T-stage (p ≤ 0.047). The recurrence rate (RR) after RCT was 34% and after RT alone 68% (p ≤ 0.04). Tumor ablation increased the RR significantly (p ≤ 0.047).
Combined chemotherapy and RT is an effective treatment of NPC disease and clearly superior to RT alone. Tumor ablation before RCT/RT worsens the prognosis and is now obsolete.
与亚洲或非洲的流行国家相比，鼻咽癌（NPC）在德国是一种罕见的肿瘤类型。这项回顾性研究调查了不同鼻咽癌治疗策略的患者特征和预后因素。
纳入了1990年至2009年期间在德国波恩大学医院接受治疗的63例鼻咽癌患者。
患者的中位年龄为56.4岁，男女比例为3.2:1，23.8%处于国际抗癌联盟（UICC）I/II期，76.2%处于III/IV期。大多数癌症为WHO III型（57.1%），其次是世界卫生组织（WHO）II型（33.3%），最后是WHO I型（9.6%）。同步放化疗（RCT）后的5年总生存率为75%，放疗（RT）后的为60%。T分期每增加一期，死亡率增加3.5倍（p≤0.047）。RCT后的复发率（RR）为34%，单纯放疗后的为68%（p≤0.04）。肿瘤切除显著增加了RR（p≤0.047）。
联合化疗和放疗是鼻咽癌的有效治疗方法，明显优于单纯放疗。RCT/RT前的肿瘤切除会恶化预后，现已过时。
