放射治疗对鼻咽癌颈部淋巴结疗效的多因素分析

目的　探讨放射治疗对鼻咽癌颈部淋巴结疗效的影响因素。方法　全组 178例鼻咽癌行单纯放射治疗 ,38例采用双侧面颈联合野 ( A组 ) ,14 0例未用面颈联合野 ( B组 )。颈部 :面颈联合野组 ( A组 )先采用超分割治疗 ,后用颈前切线常规分割 ,均采用 6 0 Co;非面颈联合野组 ( B组 )均采用常规分割 ,多为 6 0 Co颈前切线 180 KV X线。对各组性别、年龄、临床分期、放射野和分割方式对颈淋巴结疗效作单因素和多因素分析。结果　单、多因素分析 :仅 N分期与颈部淋巴结局部控制率有显著性意义。性别、年龄、T分期、放射野 (分割方式 )与颈部淋巴结局部控制率无明显相关。颈部超分割 常规分割即面颈联合野组 ( A组 )和单纯常规分割即非面颈联合野组 ( B组 )的 5年颈部淋巴结局部控制率分别为 82 .7%、83.8% ,差异无显著性 ( P=0 .6 0 4 9)。结论　 N分期是影响颈部淋巴结局部控制率的重要因素 ,不同放射野和分割方式对鼻咽癌颈部淋巴结疗效的控制无明显影响

Multivariate analysis of therapentic efficacy of radiotherapy on cervical lymph node metastasis of nasopharyngeal

Objective To analyze factors related to therapeutic efficacy of radiotherapy on cervical lymph node metastasis of nasopharyngeal cancer (NPC). Methods One hundred and seventy eight NPC patients were treated by radiotherapy, 38 patients received portals containing facial neck field (Group A),140 patients,portal not containing facial neck field (Group B). Neck: Group A was given hyperfraction radiotherapy by facial neck field and conventional radiotherapy by anterior tangential field with 60 Co. Group B was given conventional radiotherapy using anterior tangential field with 60 Co and lateral field with 180 kv X ray. Multiple factors including sex,age,clinical staging and radiotherapy regimen in two groups were analyzed. Results The 5 year local control rate of neck were 82 7%, 83 8% ( P =0 6049) in Group A and Group B, respectively. The results of univariate and multivariate analysis indicated that N stage was a significant prognostic factor for nodal control. Conclusion N stage adversely affects cervical node control in radiotherapy for NPC is confirmed. Portal and fractionation regimen may have no effect on cervical lymph node control.