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The results and prognosis of different treatment for lung metastasis from nasopharyngeal carcinoma :analysis of 60 patients
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1004-4221.2005.03.001
- Key Word:
- 鼻咽肿瘤,肺转移/放射疗法;鼻咽肿瘤,肺转移/化学疗法;预后
Abstract： 目的分析鼻咽低分化癌肺转移患者的治疗结果,寻求较为合理的治疗方案.方法对60例鼻咽癌肺转移的患者进行肺转移发生情况、治疗方式、近期疗效和远期疗效及不同治疗方式对预后影响的分析.肺转移治疗方式包括单纯化疗;局部小野照射;全肺照射+局部小野补量;全肺照射+局部小野放疗+化疗.化疗方案主要为顺铂+氟尿嘧啶+平阳霉素,全肺照射单次剂量100～150 cGy,总剂量18～21Gy;肺转移灶补量至50～60Gy,均为未校正剂量.结果鼻咽癌肺转移多为肺内多发转移,占肺转移的81.7%.45%患者在整个病程中合并其他脏器转移.肺转移后3、5年总生存率分别为35.0%、30.2%.放疗对肺转移病灶的近期疗效明显好于化疗(P=0.033).全肺照射+局部小野补量放疗后给予辅助化疗的综合治疗明显好于其他治疗方式(P=0.002).结论放疗是鼻咽癌肺转移病灶的有效治疗手段.对鼻咽局部无复发、肺内单发转移灶、不合并有其他脏器转移者,可先试行局部小野照射.对鼻咽局部无复发、肺内多发转移灶、不合并有其他脏器转移者,可行全肺照射+局部小野补量,然后给予全身化疗.对合并有其他脏器转移的,建议全身化疗.
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