摘要
回顾性分析１９８０年２月～１９９４年７月收治６２例鼻咽癌肺转移病人，经不同治疗方法的疗效比较及全肺照射的作用。肺转移全部有胸片或ＣＴ检查。鼻咽原发灶根据长沙分期，治疗均采用双面颈联合＋两相对耳前野技术，常规分割，根治性放疗。疗终颈残存１６／６２者中，发生肺转移时间中值１２月（１月～５年）。肺转移灶治疗：双侧肺转移３０例，单侧肺转移３２例。非随机性接受单化（Ｃ组）１７例，局部肺照射＋化（Ｒ＋Ｃ）１５例，全肺＋局部照射（Ｒｔ）１８例，单纯局部照射（Ｒｌ）１２例。化疗采用联合方案。局部照射采用小野，前后对穿照射，ＤＴ６０～７０Ｇｙ。全肺照射组ＤＴ１５～２０Ｇｙ，单次量ＤＴ１．０～１．８Ｇｙ后缩野，针对各个局部病灶推量至ＤＴ５０～６０Ｇｙ。６个月时生存率，Ｃ组５４．６％与Ｒｔ组及Ｒｌ组无差别，但与Ｒ＋Ｃ组比有显著差异。１２月生存率，Ｒｔ组明显好于Ｒ１组。１８个月时生存率，Ｃ组及Ｒｌ组均为０。Ｒｔ组（５９．４％）与Ｒ＋Ｃ组（１３．３％）比有显著差异。全组病人死于肺内未控或复发３３／６２，死于它因６／６２，失随１４／６２，存活９／６２。死于它因中２例系肺感染。存活９例中除１例外，均系Ｒｔ治疗组。这８例均无临床肺功能改变?
Sixty-two patients with pulmonary metastasis from NPC treated from Feb. 1980 to June 1994 were retrospectively reviewed. The aim was to compare the validity of whole lung irradiation with the other means of treatment. All patients had chest films with or without CT scans. The median interval between the discovery of residual disease in the neck nodes and the development of lung metastasis was 12 months(1～60 months) in 16/62 cases. Condition of lung metastasis: chemotherapy (multi-drug regimen) was given to 17 cases (C Group), local radiation + chemotherapy to 15 cases (R+C group), whole lung irradiation + local boost to 18 cases (RT group) and simple local irradiation to 2 cases (RI group). Local irradiation was given through A-P small protals to D T 60～70Gy. For whole lung irradiation, single doses of D T 1 5～2 0 Gy was given to both lungs until 15～20 Gy. After that, the total dose was pushed to 50-60 Gy at each focus by the conedown technic. The 18 month survival rates were: C and RI groups 0, RT group 59 4% which was conspicuously better than the R + C group (13 3%). Thirty-three patients of these 62 patients died of un-control or recurrence, six died of causes other than cancer and 14 were lost in follow-up. Nine patients are still alive, among whom all except one had been treated by the RT method. The authors believe whole lung irradiation plus local boost is indicated for lung metastasis from NPC.
出处
《中华放射肿瘤学杂志》
CSCD
1995年第3期15-17,共3页
Chinese Journal of Radiation Oncology
关键词
鼻咽癌
肺转移
全肺照射
Nasopharyngeal carcinoma Lung metastasis Whole lung irradiation
