Patterns of Distant Metastases in Nasopharyngeal Carcinoma

鼻咽癌的遠處轉移

黃志仁(Chih-Jen Huang) ； 梁雲(Stephen Wan Leung) ； 連熙隆(Shi-Long Lian) ； 王重榮(Chong-Jong Wang) ； 方富民(Fu-Min Fang) ； 何耀輝(Yau-Hui Ho)

《The Kaohsiung Journal of Medical Sciences》 12卷4期 (1996/04) Pp. 229-234

https://doi.org/10.6452/KJMS.199604.0229

摘要

近年來，隨著放射線治療技術及設備的進步，鼻咽癌的局部控制已有很大的改善，但遠處轉移仍是造成治療失敗及主要的死因之一。本文迴溯從1987年至1992年，629個鼻咽癌病患中有125個發生遠處轉移，探討其轉移的部位，發生的時問及存活期。遠處轉移的診斷依據X光片檢查、電腦斷層、骨骼掃瞄、腹部超音波及病理報告。結果顯示轉移以骨骼系統最常見（75 % )，其次為肺臟（46 %）、肝臟（38 %）及腹膜後淋巴結（10 % )，同時有多器官系統發生轉移佔57 %。骨骼系統的轉移以胸椎最為常見。發生轉移的時問多在治療後3年內發生（95% ) ，第一年、第二年及第三年發生率分別為52 %、23 %及20 %。發生轉移後的中值存活期分別為骨骼轉移（11.2個月）、肺臟轉移（16.3個月）及肝臟轉移（3.2個月）。由本研究得知骨骼系統是鼻咽癌遠處轉移最常見的部位，肺轉移及肝轉移次之，另外腹膜後淋巴轉移亦有較高的發生率。

並列摘要

The distant metastasis in nasopharyngeal carcinoma has remained the major cause of mortality and treatment failure despite better locoregional control of the disease in the past decades. Between 1987 and 1992, 125 out of 629 cases of nasopharyngeal carcinoma were found to have distant metastasis. The location of metastatic site, the timing and median survival were analyzed. The diagnosis of distant metastasis in the retrospective study was based on radiography, computed tomography, skeletal scintigraphy, ab-dominal sonography and pathology reports. The results showed that the frequencies of metastases were as follows: bone (75% of total metastatic patiepts), lung (46%), liver (38%), retroperitoneal lymph nodes (10%). Multiple organ involvement was high (57%). Most of the distant metastases (95%) occurred within 3 years after completion of radiotherapy, the first year (52%), the second year (23%) and the third year (20%). The median survival time from the discovery of distant metastasis was 11.2 months for bone metastasis, 16.3 months for pulmonary metastasis, and 3.2 months for hepatic metastasis. The results revealed that the skeletal system was the most common site of distant metastasis, followed by lung and liver. The incidence of retroperitoneal lymphadenopa-thy is higher than previous reports.

並列關鍵字

nasopharynx ； neoplasm ； distant metastasis