早期鼻咽癌手术摘除肿瘤后减量放疗可行性研究

摘要

目的：对早期鼻咽癌，手术摘除肿瘤后，减量放疗，观察远期疗效及放疗后遗症。方法：对42例早期鼻咽癌患者采用硬腭进路鼻咽部肿瘤摘除术，术后给予放疗量60～63Gy。同期的42例早期鼻咽癌患者作为对照组，给予单纯放疗，放疗量为73～80Gy。观察两组病人的5年.10年无瘤生存率，总的生存率以及生存质量。结果：治疗组和对照组5年无瘤生存率分别为41/42(97.6％)和35/42(83.3％)，两组差别有显著意义(χ2＝4.97，P＜0.05)。5年总的生存率分别为41/42(97.6％)和39/42(92.8％)。两组病人10年的无瘤生存率分别为17/21(80％)和15/20(75％)总的生存率分别为19/21(90.4％)和15/20(75％)。5年和10年的总生存率，10年无瘤生存率，两组差别无显著意义(P＞0.05)。治疗组放疗后遗症出现的程度较对照组轻。结论：早期鼻咽癌手术摘除肿瘤后减量放疗是可行的。%Objective: To study the favourite of decrease radiation dose for early stage Nasopharyngeal Carcinoma (NPC)after surgery.Methods:Eighty four cases of early stage NPC as objects since 1987 till 1993.Among them 42 cases had undergon surgery (CT group) via palatal fenestration and received radiation with the dose of 60～63Gy. Other 42 cases (RTgroup)were recived single radiation with the dose of 73～80Gy. All cases have been follow－up regularly to observation the free tumour rate, survival rate and the side－effect of radiation.Results: The five－years survival rate of free tumour were 99.6% (41/42) in CTgroup and 83.3% (35/42) in RT group. Between both of group (P＜0.05) the difference was significant.The five－years survival rate were 97.6% (41/42) in CT group and 92.8% (39/42) in RT group respectively (P＜0.05).The ten －years survival rate of free tumour were 80% (17/21) in CT group and 71% (15/20) in RT group respectively (P＞0.05).The ten－years survival rate were 90.4% (19/21) in CT group and 71% (15/21) in RTgroup respectively (P＞0.05). The complication associated radiatherapy was slighter in CT group than in RT group. Conclusion: It suggests that decrease radiation dose for early stage NPC after surgery was favourite.