Vikram B, Strong E W, Manolatos S, Mishra U B
Head Neck Surg. 1984 Dec;7(2):123-8. doi: 10.1002/hed.2890070206.
Between 1970 and 1980, we treated 107 previously untreated patients with biopsy-proven carcinoma of the nasopharynx by megavoltage external radiation therapy to the primary site, base of the skull, and both sides of the neck. Eighty-seven percent of the patients had stage IV disease (American Joint Committee 1980), 53% had T4 primaries, and 73% had palpable cervical metastases. The histology was anaplastic or poorly differentiated carcinoma in 81%. The observed 5-year survival rate was 35% for the patients treated between 1970 and 1976, and increased to 72% for those treated between 1977 and 1980 (P less than 0.01). The two patient populations were similar except that the dose of irradiation (median and modal) to the primary site was 6,000 rad during 1970-1976 and 7,000 rad during 1977-1980. The survival rate was not significantly influenced by age, sex, birthplace, histology, or stage. These data suggest that a relatively high cure rate might be possible in carcinoma of the nasopharynx, even though most patients present with locally advanced disease. The patterns of relapse are discussed.
1970年至1980年间，我们对107例经活检证实为鼻咽癌的初治患者进行了治疗，采用兆伏级外照射治疗原发部位、颅底及双侧颈部。87%的患者为IV期疾病（美国联合委员会，1980年），53%的患者原发灶为T4期，73%的患者可触及颈部转移。组织学类型为间变性或低分化癌的占81%。1970年至1976年间接受治疗的患者观察到的5年生存率为35%，而1977年至1980年间接受治疗的患者5年生存率提高到72%（P小于0.01）。这两组患者相似，只是1970 - 1976年间对原发部位的照射剂量（中位数和众数）为6000拉德，1977 - 1980年间为7000拉德。生存率不受年龄、性别、出生地、组织学类型或分期的显著影响。这些数据表明，即使大多数患者就诊时已处于局部晚期，鼻咽癌仍有可能获得相对较高的治愈率。本文还讨论了复发模式。
