摘要
目的 :根据不同性质将鼻咽癌鼻腔受侵区分为两种类型 ,评价其对放射治疗后局部控制和远期生存等预后的影响。方法 :从 1989年 11月至 1991年 7月共收治经病理证实的首程放疗鼻咽癌病人 2 18例 ,87例鼻腔受侵。所有病人均行治疗前CT扫描 ,放疗前、中、后和每次随访都用纤维镜检查鼻咽。采用 6 0Co外照射 ,未行近距离照射或化疗。结果 :6 0例为粘膜浸润型 (MI) ,2 7例为游离突入型 (EP) ;两组放疗后肿瘤残留率、局部复发率、5年无病生存率和局部复发死亡率之比分别为 36 7%比 3 7% ,30 0 %比 7 4% ,2 6 7%比 5 1 8%和 2 5 0 %比3 7% ,P值分别为P <0 0 0 4、P <0 0 0 5、P <0 0 2和P <0 0 3。结论 :将鼻腔受侵分为MI和EP有利于估计预后 ,我们建议在临床分期中只将MI列为鼻腔受侵。
Objective:The purpose of this study was to differentiate the involvement patterns of nasal fossa involvement in nasopharyngeal carcinoma (NPC) and to clarify its prognostic influence on local control and survival after radiation therapy Method and materials:Between November 1989 and July 1991, 218 patients with histological proven local regional NPC were treated with radiotherapy following the protocol at the Department of Radiation Oncology, Cancer Hospital, Shantou University School of Medicine All patients had pretreatment CT scans Fiberoptic endoscopic examination was performed every week during treatment and at the time of every follow up visit to define the initial extent of disease and to evaluate treatment response Based upon the fiberscope finding, we separated nasal fossa involvement into two types:exophytic protruding (EP), which indicated exophytic bulky tumor arising from the nasopharynx and protruding into the nasal fossa, and mucosal infiltration (MI), which indicated that the nasal cavity mucosa was clinically infiltrated by tumor Of the 218 patients, 87 had nasal involvement Sixty of them had a pattern of MI and another 27 had an EP component No chemotherapy or brachytherapy was given Results:The likelihood of residual disease after irradiation, the local relapse rate, 5 year freedom from progression rate (FFP) and death rate associated with nasopharynx relapse (DRANP) of MI and EP were 36 7%vs 3 7%, 30 0%vs 7 4%, 26 7%vs 51 8%and 25 0%vs 3 7%with P< 0 004, P < 0 005, P< 0 02 and P< 0 03, respectively Patients with local relapse in the EP group were all limited to nasopharynx, while in the MI group, recurrence sites included 67%of NP (12/18), 28%of nasal cavity (5/18), 11%of parapharyngeal space (2/18) and 11%of base of skull (2/18) Multivariate analysis in this selected group demonstrated that infiltration of nasal fossa mucosa was an independent prognostic factor on primary control and freedom from progression Conclusion:Differentiation of nasal fossa involv
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第5期463-467,共5页
Chinese Journal of Cancer
基金
美国HoTim Stanley HoandLi Ka hingStanfordUniversityMedicalFund提供资助
关键词
鼻咽肿瘤
放射疗法
鼻腔受侵
临床分期
Nasopharyngeal neoplasms
Radiotherapy
Nasal fossa
Clinical staging
