论文摘要
目的回顾性分析我科鼻咽癌治疗疗效和晚期并发症的发病情况,并分析其影响因素。方法随访在我科接受根治性放射治疗196例鼻咽癌患者,所有病人均接受6MV-X线面颈联合野和颈部切线野常规外照射,剂量范围6480Gy。其中37例（T3、T4或N2、N3）患者接受24周期化疗,方案均采用5-FU+DDP（5-FU 500mg/m2d1-3、DDP 30mg/ m2d1-3,每3周为1周期）。肿块退缩情况通过CT、MRI评价,分析预后的相关影响因素。同时调查鼻咽癌患者放疗后的晚期并发症。结果全组患者5年和10年的总生存率分别为53.10%和39.90%。单因素分析发现,性别、临床分期、T分期、N分期、原发灶剂量和下颈淋巴引流区剂量是影响预后的因素。多因素分析仅提示临床分期明显影响预后。口干、听力下降和放射性龋齿最常见的并发症,2级以上的发生率分别为48.96%、23.96%和20.83%。口干无明显相关因素。原发灶剂量与张口困难、听力下降有明显的相关性（P=0.012,0.007）。应用不规则整体挡铅技术对放射性龋齿的影响具有显著性（P=0.001）。颈部局部肿块的剂量是颈部皮下纤维化的明显影响因素（P=0.000）。结论临床分期与预后相关,正常组织受照剂量与后遗症有关。需采用综合手段提高疗效,降低并发症。
论文目录
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