鼻咽癌的遠端轉移

Distant Metastasis in Nasopharyngeal Carcinoma

10.6316/TRO/199603(4)229

曾振淦(C. K. Tseng)；曾雁明(N. M. Tsang)；劉千如(C. J. Liu)；陳玉萍(Y. P. Chen)；湯國政(G. J. Tang)

鼻咽癌 ； 遠端轉移 ； Nasopharyngeal cancer ； Distant metastases

放射治療與腫瘤學

3卷4期（1996 / 12 / 01）

229 - 232

繁體中文

目的：這是一篇有關於鼻咽癌治療後發生遠端轉移的回溯性分析。針對252位在林口長庚醫院放射腫瘤科接受過根除性放射治療後產生遠端轉移的鼻咽癌病患，來觀察鼻咽癌遠端轉移的時間性、轉移區域的好發性、及對預後影響等因素。 材料與方法：從1979年4月到1990年12月期間，共有l195位鼻咽癌病患接受根除性放射治療，之後有252位患者在追蹤檢查發現有遠端轉移的跡象。 結果：在發生轉移的部位上，以骨骼、肝臟、及肺臟轉移最為常見。有48%的病人在治療後一年內被發現轉移，兩年內被發現的比率是73%，而五年後發生遠端轉移的機會則低於5%。發現轉移後的存活時問，中位數為8個月，1年後存活率為35%，而2年為12%。 結論：鼻咽癌患者在發現遠端轉移之後的存活時間，大多數都在2年之內。在發生轉移的部位上，以骨骼轉移最為常見。

Purpose: To study the interval between the incident of distant metastases and radical radiotherapy, the preferable metastatic sites, and the survival after metastases in nasopharyngeal carcinoma (N PC) patients. Materials and Methods: One thousand one hundred and ninety-five (1195) NPC patients had completed local treatment of radiotherapy in radiation oncology department at Chang Gung Memorial Hospital from April 1979 to Dcecember 1990. Two hundred fifty-two patients (21%) were found to have distant metastases by the end of August 1996. Results: Bone, liver, and lung were the most common metastatic sites. Forty-eitht percent metastases happened within 1 year and 73% within 2 years. Less than 5% of distant metastases occurred 5 years after primary nasopharyngeal irradiation. Most of the patients died within one year (8 months median survival) after distant metastases had been diagnosed. The post distant mestastases survival rates in one and two years were 35% and 12% respectively. Discussion: The majority of patients died within 2 years after distant metastases were diagnosed. Most of the distant metastases happened within 2 years after radiotherapy, skeletal metastases were the most common site.