影响N0期鼻咽癌放射治疗后颈淋巴结复发因素分析

目的分析颈淋巴结阴性(N0)鼻咽癌放射治疗后颈淋巴结复发的影响因素。方法采用Logistic回归方法回顾性分析接受放射治疗的N0期鼻咽癌211例复发因素。结果211例N0期鼻咽癌放射治疗后49例复发。采用面颈联合野放射治疗，上颈预防剂量>50 Gy比面颈分野上颈剂量50 Gy者颈淋巴结复发率低（t=12.93，P=0.000)。咽旁间隙受侵，T分期高，颈淋巴结复发率高（t=14.91，P=0.001及t=8.78，P=0.003)。全颈预防照射比单纯上颈预防照射的下颈复发率低（χ

The risk factors of cervical lymph node recurrence after radiotherapy for neck n egative nasophargneal carcinoma.

Objective To analyze the risk factors of cervical lymph node recurrence in N0 nasopharyngeal carcinoma (NPC). Methods From January 1987 to December 1996, 211 NPC patients without cervical lymph node involvement were treated with radiotherapy alone. Retrospective univariate and multivariate analyses were perfResults Forty nine patients of these 211 patients developed recurrence in the cervical lymph nodes. The cervical lymph node recurrence rate was lower in patients treated with conjoint facio cervical fields to >50 Gy in the upper neck as compared to those treated with seperate facial and neck fields to <50 Gy in the upper neck (P= 0.000 ). The parapharyngeal involvement and high T stage lesion are risk factors for neck node recurrence (P=0.001 and P= 0.003 ). The neck recurrence in patients who received prophylactic whole neck irradiation was lower than those who received prophylactic upper neck irradiation(P>0.05)Conclusions We suggest that patients with neck negative NPC should be treated with conjoint facio cervical lateral fields and prophylactic whole neck irradiation with more than 50 Gy to the upper neck.