62例鼻咽癌常规放疗5年后局部区域复发的再程常规放疗分析

目的 了解鼻咽癌患者放疗后的远期(疗后5年以上)局部区域复发情况,以及复发患者再程治疗的预后.方法 2000年前10年经病理组织学确诊并接受旨程常规放疗的鼻咽癌患者1384例中局部区域复发350例,疗后至复发时间6-171个月.5年后复发62例,其中鼻咽复发41例,颈部复发19例,鼻咽+颈部复发2例.62例中37例接受了再程常规放疗,其中1例颈部淋巴结复发者再程常规放疗4年后再次复发,接受第3程常规放疗;25例末接受再程常规放疗,其中1例颈部淋巴结复发行外科颈清扫,余因各种原因未接受再次治疗或仅行对症处理.结果 全部随访到的患者(1277例)中复发后无再放疗者中位生存14个月(95%CI=7.1～20.8个月),无5年生存;接受冉程放疗者中位生存44个月(95%CI=30.4～57.6个月),5年生存率达42%.结论 鼻咽癌常规放疗5年后仍有局部区域复发,复发患者再程放疗预后较好.

Late local-regional recurrence of nasopharyngeal carcinoma after conventional radiotherapy

Objective To investigate the local-regional recurrence of nasopharyngeal carcinoma (NPC) 5 years after conventional radiotherapy and its prognosis.Methods From August 1989 to Decem ber 1999,1384 patients with newly histo-pathologicatly diagnosed NPC were treated with conventional radia tion.350 out of 1277 followed-up patients were diagnosed as local-regional failure.The intervals between completion of radiation and tumor relapse ranged from 6 months to 171 months.There were 62 patients with local-regional recurrence 5 years after the radiotherapy,including 41 in nasopharynx,19 in neck and 2 in na sopharynx and neck simultaneously.Thirty-seven patients with late local-regional recurrence received a sec ond course conventional radiotherapy.Results The median survival time was 44 months(95% CI = 30.4 -57.6) of patients with re-irradiation comparing with 14 months (95% CI = 7.1-20.8) of those without. The 5 year survival rate after re-irradiation was 42%.Conclusions Local-regional recurrence of nasopha ryngeal carcinoma can oeoure 5 years after radiotherapy.Second course converntional radiotherapy possesses good results.