国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
20期
2496-2499
,共4页
李坊铭%陈国健%张钦华%程霞
李坊銘%陳國健%張欽華%程霞
리방명%진국건%장흠화%정하
鼻咽肿瘤%放射治疗%化疗%远处转移%淋巴结活检%预后
鼻嚥腫瘤%放射治療%化療%遠處轉移%淋巴結活檢%預後
비인종류%방사치료%화료%원처전이%림파결활검%예후
Nasopharyngeal neoplasms%Radiotherapy%Chemotherapy%Metastasis%Lymph node biopsy%Prognosis
目的 分析已行颈部淋巴结活检鼻咽癌疗效的预后影响因素.方法 2006年1月至2006年12月,本院共收治48例治疗前已行颈部淋巴结切取或活检的鼻咽癌病例,鼻咽病理均确诊为鼻咽未分化型非角化性或角化性癌,均采用常规根治性放疗,部分病例给予放化综合治疗.结果 全组复发率14.5％,远处转移率52.1％,4年总生存率43.6％；单纯放疗组和放化疗组的4年远处转移率分别73.3％、42.4％(P＜ 0.05),生存率分别为26.3％、55.2％(P＜0.05);活枪术与放疗间隔时间≤15天组和＞15天组的4年远处转移率分别37.9％、73.7％(P＜ 0.05),生存率分别为54.5％、20.0％(P＜0.05);活检淋巴结剂量＞64Gy和活检组淋巴结剂量≥64Gy的4年远处转移率分别75.0％、40.6％(P＜ 0.05),生存率分别为25.0％、53.1％(P＞ 0.05).结论 颈部淋巴结活枪术后预后差,应尽早治疗,可考虑放化综合治疗,放疗剂量应≥64Gy,由于本研究观察时间短,病例数有限,其远期结果有待于更多临床资料的积累和更长时间的观察.
目的 分析已行頸部淋巴結活檢鼻嚥癌療效的預後影響因素.方法 2006年1月至2006年12月,本院共收治48例治療前已行頸部淋巴結切取或活檢的鼻嚥癌病例,鼻嚥病理均確診為鼻嚥未分化型非角化性或角化性癌,均採用常規根治性放療,部分病例給予放化綜閤治療.結果 全組複髮率14.5％,遠處轉移率52.1％,4年總生存率43.6％；單純放療組和放化療組的4年遠處轉移率分彆73.3％、42.4％(P＜ 0.05),生存率分彆為26.3％、55.2％(P＜0.05);活鎗術與放療間隔時間≤15天組和＞15天組的4年遠處轉移率分彆37.9％、73.7％(P＜ 0.05),生存率分彆為54.5％、20.0％(P＜0.05);活檢淋巴結劑量＞64Gy和活檢組淋巴結劑量≥64Gy的4年遠處轉移率分彆75.0％、40.6％(P＜ 0.05),生存率分彆為25.0％、53.1％(P＞ 0.05).結論 頸部淋巴結活鎗術後預後差,應儘早治療,可攷慮放化綜閤治療,放療劑量應≥64Gy,由于本研究觀察時間短,病例數有限,其遠期結果有待于更多臨床資料的積纍和更長時間的觀察.
목적 분석이행경부림파결활검비인암료효적예후영향인소.방법 2006년1월지2006년12월,본원공수치48례치료전이행경부림파결절취혹활검적비인암병례,비인병리균학진위비인미분화형비각화성혹각화성암,균채용상규근치성방료,부분병례급여방화종합치료.결과 전조복발솔14.5％,원처전이솔52.1％,4년총생존솔43.6％；단순방료조화방화료조적4년원처전이솔분별73.3％、42.4％(P＜ 0.05),생존솔분별위26.3％、55.2％(P＜0.05);활창술여방료간격시간≤15천조화＞15천조적4년원처전이솔분별37.9％、73.7％(P＜ 0.05),생존솔분별위54.5％、20.0％(P＜0.05);활검림파결제량＞64Gy화활검조림파결제량≥64Gy적4년원처전이솔분별75.0％、40.6％(P＜ 0.05),생존솔분별위25.0％、53.1％(P＞ 0.05).결론 경부림파결활창술후예후차,응진조치료,가고필방화종합치료,방료제량응≥64Gy,유우본연구관찰시간단,병례수유한,기원기결과유대우경다림상자료적적루화경장시간적관찰.
Objective To explore the influence facter of neck lymph node biopsy on the prognosis for NPC.Methods 48 NPC cases taken cervica lymph node metastases were treated by radiotherapy from January,2006 to December,2006.Analyzed recurrence and 4-year survival rates.Results The rates of recurrence and distant metastasis were 14.5％ and 52.1％; and overall 4-year survival rate was 43.6％ in the 48 cases.The rate of metastasis was 73.3％ in Radiotherapy alone group(Group A),and 42.4％ in chemotherapy group(Group B)(P=0.015); and overall 4-year survival rates were 26.3％ and 55.2％,respectively in the both groups(P=0.049).The metastasis rate was 37.9％ in the patients treated within 15 days( Group C ),while 73.7％ beyond 15 days(Group D) (P=0.047); and overall 4-year survival rates were 54.5％ and 20.0％,respectively in the both groups(P=0.025); The metastase rates were 75.0％ for the dose of cervical lymph node under 64Gy(Group E),and 40.6％ for the dose above 64 Gy (Group F),P=0.025;and overall 4-year survival rates were 25.0％ and 53.1％,P=0.064.Conclusion The neck lymph node biopsy can increase the rate of distant metastasis and decrease the rate of survival for NPC,so early radiotherapy,chemotherapy,and the dose above 64Gy can improve the clinical effect of NPC.The longterm treatment result need enrolling more patients and long-term follow-up.
