119例鼻咽癌放疗后死于远处转移病例分析及放化研讨

 我院自1975-1980年放射治疗鼻咽癌1101例,相对五年生存率50.1%.五年内已知死亡原因的321例中,119例死于远处转移,占死亡者37.1%.死于远处转移者第一年内占52.9%,第二年占30.3%.这表明放疗后死于远处转移者绝大多数发生在前1~2年内.远处转移多发部位为骨(37%)、肺和肝(各占21%).病期愈晚死于远处转移就越高,Ⅰ~Ⅱ期占14.5%,Ⅲ~Ⅳ期占85.5%.其中以颈淋巴结转移的大小和活动度关系最为明显.N₀死于远处转移率占0.76%,N₁占11.8%,N₂、N₃占80.7%.从病理来看,未分化癌和低分化癌易发生远处转移(占75.6%).因此鼻咽癌颈淋巴结N₂、N₃病人在放疗前和放疗后1年内采取有计划的化学药物治疗是值得考虑的课题.

Analysis and Discussion of 119 Cases NPC Dead of Metastasis After Radiotherapy

Abstract Since 1975 to 1980, 1101 cases of nasopharyngeal carcinoma were treated by radiation treatment in our hospital. 119 cases of 321 (37. 1 %) cases died within five years, of which 52, 9% died of metastasis at the first year, and 30. 3% the second year. 14. 5 % of these cases were stage Ⅰ to Ⅱ, and 85. 5% were stage Ⅲ to Ⅳ. The size and mobility of lymph nodes in neck are very important. Ohly 0. 76% No cases died of metastasis, but N₁ is 11. 8%, and N₂, N₃ are 80.7%, Lowly differentiated carcinoma and undifferentiated carcinoma are prone to metastasize (75. 6%). The most frequent site of NPC metastasis occurs in bone, then lung and liver.To raise survival rates of NPC by radiation treatment, it is important to try to control metastasis. Chemotherapy is effective to treat cancer of head and neck, so it should be considered for NPC patients with N₂, N₃ lymph nodes. Chemotherapy can be given systematically within one year, before and after radiotherapy.