摘要
目的 探讨局部晚期鼻咽癌的综合治疗方法 ,以期望提高疗效。方法 自 1993年 1月～ 1998年 12月 ,局部晚期鼻咽癌首程病人 4 3例于本科治疗。全部经病理证实 ,39例为鳞癌 ,4例为未分化癌。采用 1992年全国鼻咽癌福州会议制定的鼻咽癌分期方案进行分期 :Ⅲ期 2 4例 ,Ⅳ期 19例。病理为未分化癌者放化疗同时进行。鳞癌患者先放疗后化疗。放疗先采用面颈联合野放疗 36～ 4 2Gy ,之后面颈分野 ,避开脊髓 ,鼻咽部继续放疗至根治剂量 6 6～ 76Gy ,对其中经鼻咽计算机体层摄影术证实有残存者 2 5例 (T4患者除外 )外照射后补充近距离治疗 2～ 4次 ,近距离总剂量为 12～ 18Gy。外照射后有残存者 3例 ,由于残存病灶位于颅底及海绵窦 ,所以给予伽玛刀补充放射剂量 6～ 9Gy。放疗结束后 1～ 2周 ,开始行化疗 ,化疗药物为顺铂或卡铂、5 氟尿嘧啶、甲酰四氢叶酸钙 ,共进行 3～ 4个疗程。结果 以放疗结束计算生存期 ,总的 3年局部控制率及生存率分别为 6 2 8%和 6 7 4 % ,总的 5年控制率和生存率分别为 39 1%和 4 3 5 %。随访期内未见严重并发症。结论 本文对晚期鼻咽癌采用以放疗为主的综合治疗 ,疗效比较满意。根治性外放疗剂量后采用近距离治疗或伽玛刀补量 ,只要合理设计 。
Objective To study the clinical effect of advanced nasopharyngeal carcinoma(NPC) that was treated by the combining therapy. Methods From January 1993 to December 1998, 39 cases with squamous carcinoma in 43 patients with advanced nasopharyngeal carcinoma were treated by radical external radiotherapy(66～75 Gy) first and then gave the chemotherapy. 4 cases with undifferentiated cancer cell at the same time were treated by the external radiotherapy and chemotherapy. 25 cases with local residul lesion were treated by brachytherapy The dose of brachytherapy was 12～18 Gy/2～4 F/2 weeks. 3 cases with infiltrating cranial basis or cavernosus sinus were treated by γ knife. The dose of γ knife was 6～8 Gy. Then all patients(43 cases) with NPC were treated by the chemotherapy for 3～4 courses. Results The 5 year local control rates and 5 year survival rates were 39 1% and 43 5% respectively. The serious complications of radiotherapy were not seen. Conclusion Combining therapy is useful for the advanced nasopharyngeal carcinoma.
出处
《海军总医院学报》
2002年第4期216-218,共3页
Journal of Naval General Hospital of PLA
