鼻咽癌咽后淋巴结转移与预后关系分析

目的探讨鼻咽癌患者咽后淋巴结转移与复发、转移及预后的关系。方法收集2007-01～2007-12间,本院病理确诊鼻咽非角化性或未分化癌,分期为Ⅱ～Ⅳa(2008年广州鼻咽癌分期标准)患者102例,根据MR检查结果分为:无咽后淋巴结转移、单侧咽后淋巴结转移及双侧咽后淋巴结转移3组,Ⅱ期患者采用常规鼻咽癌根治性放疗;Ⅲ～Ⅳa期患者采用常规鼻咽癌根治性放疗及同期放化疗或辅助性化疗。治疗结束后,定期复查鼻咽及颈部MRI、胸腹部CT、全骨ECT,所有患者随访2年,判断患者是否出现局部复发及远处转移。结果 102例患者均按计划完成全程放疗,同期化疗为顺铂(Cisplatin)30 mg/(次.周)-1×7方案,辅助性化疗为PF方案2～4个疗程,所有患者近期完全缓解率100%。随访2年3,组患者之间2,年局部复发或远处转移发生率之间具有统计学意义(P﹤0.05);加入分期因素,Ⅲ期患者3组患者之间2年局部复发或远处转移发生率之间具有统计学意义(P﹤0.05);Ⅳa期患者3组患者之间2年局部复发或远处转移发生率之间无统计学意义(P﹥0.05)。结论鼻咽癌患者咽后淋巴结转移属于高危预后因素之一,较易发生局部复发及远处转移。

The Prognosis of Retropharyngeal Lymph Node Metastasis of Nasopharyngeal Carcinoma

Objective To evaluate the relationship between retropharyngeal lymph node(RLN) metastasis of nasopharyngeal carcinoma and recurrence,metastasis and prognosis.Methods 102 cases of nasopharyngeal carcinoma,who were diagnosed by pathology as non-keratinizing or undifferentiated,stage of Ⅱ～Ⅳa(2008 staging of nasopharyngeal carcinoma in Guangzhou),From January 2007～December 2007,were divided into without RLN metastasis,unilateral and bilateral RLN metastasis three groups according to MR imaging results.Ⅱ stage nasopharyngeal carcinoma was treated with conventional radical radiotherapy,Ⅲ～Ⅳa stage patients were porformed conventional nasopharyngeal carcinoma radical radiation therapy and concurrent chemotherapy and radiotherapy or adjuvant chemotherapy.Nasopharynx and neck MRI and chest and abdominal CT,whole bone ECT were periodically reviewed.All patients were followed for 2 years to determine whether the patient had local recurrence and distant metastasis.Results All patients completed the whole according to plan radiation therapy.Same period chemotherapy was Cisplatin 30 mg/times/week×7.Adjuvant chemotherapy was PF program and 2～4 process.All patients were followed-up for 2 years and near complete remission rate was 100%.The incidence local recurrence or distant metastasis among three groups have statistically significant(P<0.05);Adding staging factors,2-year local recurrence or distant metastasis rate of Ⅲ stage patients among three groups have statistical significance(P<0.05).And 2 years local recurrence or distant metastasis of Ⅳa stage patients among three groups has not significant between(P>0.05).Conclusion Retropharyngeal lymph node metastasis of nasopharyngeal carcinoma mightbe high risk prognostic factors.It was prone to local recurrence and distant metastasis.