Qin D X, Hu Y H, Yan J H, Xu G Z, Cai W M, Wu X L, Cao D X, Gu X Z
Cancer Hospital, Chinese Academy of Medical Sciences.
Zhonghua Zhong Liu Za Zhi. 1988 May;10(3):217-9.
This paper presents 1379 patients with nasopharyngeal carcinoma treated in our hospital from March 1958 to December 1978. The stage I and II lesions comprised 22% and stage III and IV lesions, 78%. 220 KV X-ray was used before 1960 and 60Co was predominant from 1961 through 1978. The overall 5 year survival rate was 41.4% (571/1379). Young adults and female patients gave better results. The 5 year survival rate was, according to pathological type, 45.1% for poorly differentiated squamous cell carcinoma and 13% for adenocarcinoma; according to clinical stage, 85.7% for stage I lesion, 59.5% for stage II, 45.8% and 29.2% for stages III and IV; according to period of treatment, 31.3% in the sixties and 48.6% in the seventies; according to tumor dose at the primary focus, 48.2% for 40-49 Gy, 55.6% for 60-69 Gy and 67.3% for 90 Gy or more; according to with or without prophylactic radiation in the neck region, 53.8% for the former and 23% for the latter. It implies that prophylactic radiation of the neck is necessary regardless of the presence of cervical lymph node metastasis or not. For those who had residual tumor at 70 Gy, the total dose may be boosted to more than 90 Gy with the cone down technic or the dose, at which the primary lesion disappears grossly, is added with 20 Gy. The common complications are radiation myelitis, trismus and otitis media. As in certain patients, the lesion would still recur 5 years after radiotherapy, the authors believe that the nasopharyngeal cancer patients should be followed for ten years at least.
本文介绍了1958年3月至1978年12月在我院接受治疗的1379例鼻咽癌患者。Ⅰ期和Ⅱ期病变占22%，Ⅲ期和Ⅳ期病变占78%。1960年前使用220千伏X射线，1961年至1978年以60钴为主。总体5年生存率为41.4%（571/1379）。年轻成年人和女性患者的治疗效果较好。根据病理类型，低分化鳞状细胞癌的5年生存率为45.1%，腺癌为13%；根据临床分期，Ⅰ期病变为85.7%，Ⅱ期为59.5%，Ⅲ期和Ⅳ期分别为45.8%和29.2%；根据治疗时期，60年代为31.3%，70年代为48.6%；根据原发灶肿瘤剂量，40 - 49戈瑞为48.2%，60 - 69戈瑞为55.6%，90戈瑞及以上为67.3%；根据颈部是否进行预防性放疗，前者为53.8%，后者为23%。这表明无论颈部有无淋巴结转移，颈部预防性放疗都是必要的。对于70戈瑞时仍有残留肿瘤的患者，可采用缩野技术将总剂量提高到90戈瑞以上，或在原发灶大体消失的剂量基础上增加20戈瑞。常见并发症为放射性脊髓炎、牙关紧闭和中耳炎。由于某些患者放疗后5年仍会复发，作者认为鼻咽癌患者至少应随访10年。
