鼻咽癌之放射線治療－225病例患者之研究分析

三軍總醫院放射腫瘤部自民國65年元月至71年9月，共有未遠端轉移之鼻咽癌患者225例，並接受單獨放射線治療。其中男性158例，女性67例，年齡分佈由14歲至75歲，平均年齡為45歲。所有患者在治療前均經組織病理切片加以證實，其中鱗狀上皮癌佔61.4 %，而未分化癌佔37.7%。所有患者均接受根除性分程（split-course）放射線治療，而治療劑量為在八週內給予鼻咽部位7000厘葛雷（cGy），而在兩側頸部及鎖骨上下窩依其淋巴腺侵犯程度之不同在五至七週內給予5000～7000厘葛雷，但在劑量達到4000厘葛雷時，給病人休息二至三星期。除22位患者未持續門診追蹤外，其餘均追蹤滿5年。依其期別之不同，其5年保險存活率為：第I期，94.4%；第II期，77.8%；第III期，70.3 %及第IV期，53.6 %。本文同時也對一些預後因素進行分析，發現期別及頸部切開手術會影響預後，至於性別、年齡及組織病理形態之影響則無統計上的意義。

關鍵字

放射線治療；鼻咽癌

並列摘要

From January 1976 to September 1982, 225 consecutive patients with a histologically confirmed malignant ”tumor” of the nasopharynx were evaluated and treated by definite megavoltage irradiation in the Department of Radiation Oncology of the Tri-Service General Hospital. Patients with known distant metastases at presentation (M1) were excluded from this study analysis. The study was comprised of 158 males and 67 females their ages ranged from 14 to 75 years (mean age, 45 years). The primary tumors were histologically classified into two major types, squamous cell carcinoma in 61.4% and undifferentiated carcinoma in 27.1%. All patients were put on a split-course treatment protocol which included a 2-3 week interruption when the tumor dose reached 4000 cGy and a minimal tumor dose of 7000 cGy in 35 increments for 10-11 weeks to the primary site. In addition, the neck and supraclavicular fossae received a basic tumor dose of 5000 cGy. If there were palpable lymph nodes, an additional 1000-2000 cGy were given. All patients, but 22, had 5-year minimum follow-up. Five-year acturial survival rate according to stages were as follows: stage I, 94.4%; stage II, 77.8%; stage III, 70.3%; and stage IV, 39.4%. The purpose of analysis was to determine patient and tumor factors influencing survival. In our study, the factors influencing sruvival included stage an dcervival lymphnode biopsy. On the other hand, no signficant patient factor was observed which influenced survival.

並列關鍵字

Radiotherapy ； Nasopharyngeal carcinoma

國際替代計量

鼻咽癌之放射線治療－225病例患者之研究分析

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