鼻咽癌常规放射治疗后10年以上生存者的随访观察

[目的]研究经常规放射治疗后生存10年以上的鼻咽癌患者的生存状况。[方法]对接受放射治疗后,生存超过10年且有完整随访复查资料的342例鼻咽癌患者,进行肿瘤控制情况和放疗晚期并发症调查。所有病人均接受过常规放疗,鼻咽中位剂量70Gy,颈部转移性淋巴结中位剂量66Gy,淋巴结阴性者颈部剂量50Gy。有54例病人给予同期化疗。中位随访期14年（10-23年）。[结果]342例中,在首程放疗的10年后,有27例局部区域复发,4例发生远处转移。10年后死亡24例,其中因鼻咽癌复发或转移死亡11例,为第1位死因;吞咽障碍导致死亡5例,为第2位死因。264例病人（79.7%）有1种或1种以上不同程度的晚期并发症。其中有1种或1种以上的3、4级严重并发症者98例,占所有病人的28.6%。[结论]鼻咽癌常规放疗后长期生存者大多存在不同程度的晚期并发症,部分存在影响正常生活的3、4级严重晚期并发症。放疗后生存10年以上者,仍可能发生局部区域肿瘤复发或者远处转移。

Over 10 Years Follow-up for Survivors with Nasopharyngeal Carcinoma After Conventional Radiotherapy

[Purpose] To investigate the outcomes of follow-up for the nasopharyngeal carcinoma（NPC） patients who survived over 10 years after conventional radiotherapy. [Methods] Cancer control and late complications in 342 followed-up NPC cases being alive over 10 years after radiotherapy were investi- gated. These cases were treated with conventional radiotherapy,with a median dose of 70Gy for nasopharyngeal lesion, 66Gy for the neck in the cases with neck lymph node metastasis,50Gy prophylactic dose for the neck with negative node. Fifty-four cases received chemotherapy. The median follow-up was 14 years （rang 10N23 years）. [Results]There were 27 cases with local-regional cancer relapse,4 cases with distance metastasis. Twenty-four cases died 10 years after initial radiotherapy,among them 11 died of NPC recurrence or distant metastases,which accounted for the first cause of death;5 cases died of dysphagia,ranked the second cause of death.Two hundred and sixty-four casess （79.7%） occurred 1 or more late complications,and 98 of them （28.6 %） had 1 or more kind of late comlications with grade 3 or grade 4. [Conclusionl Various late complications exist in most long-term survivors with NPC after conventional radiotherapy. Partial of the survivors suffer from grade 3 or grade 4 complications which seriously affect the patients＇ quality of life. Regional recurrence or distant metastasis might occur in long-term survivors.