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目的探讨２０年来鼻咽癌（ＮＰＣ）放射治疗技术的变革和其疗效变化的关系。方法选职在确定靶区和野界定位及放射治疗技术上各有代表性的１９７１年组１４２例。１９７６年组２０１例和１９９１年组２３２例全部初治的ＮＰＣ病人，对比其长期疗效和后遗症情况。１９９１年组全部用ＣＴ确定靶区和野界定位。７０年代２个组皆用面颈分野技术，并以耳前野为主野，１９７６年组加用全颈前切线野；１９９１年组改以面颈联合野为主野，并停用或减少上颈前切线野的剂量，颈淋巴结的剂量以电子束补足。１９９１年组的原发灶和颈淋巴结剂量分别提高约１５％和１７％。结果１９９１年组的各项长期疗效指标均明显优于７０年代的２个组，而后遗症发生率未上升。１９９１年组的寿命表达５年总生存率、无癌生存率、局部控制率和无远地转移率分别为７４．５％，５６．１％，８７．９％和８２．６％。结论应用ＣＴ及面颈联合野和合理提高剂量可改善ＮＰＣ放射治疗疗效。
Objective To explore the relationship between the change of radiotherapy technique and its therapeutic effect in nasopharyngeal carcinoma (NPC) over the past 20 years. Methods Selecting the professors in the target area and the field to determine the positioning and radiotherapy techniques were representative of the 1971 group of 142 cases. 201 cases of 201 cases and 1991 group of 232 cases of all untreated NPC patients, compared to its long-term efficacy and sequelae. In 1991, all the groups used CT to determine the target area and the field position. In the 1970s, the two groups were using facial and neck technique, and the ear field as the main field, 1976 group plus the whole neck anterior tangent line; 1991 group to face and neck joint field as the main field, and to disable or reduce the The dose of tangential field before neck, the dose of cervical lymph node to make up by electron beam. In 1991, the primary and cervical lymph nodes were increased by about 15% and 17% respectively. Results 1991 long-term efficacy of the group were significantly better than the 70’s in the two groups, and the incidence of sequelae did not rise. The 5-year overall survival, cancer-free survival, local control, and distant metastasis in 1991 were 74.5%, 56.1%, 87.9% and 82.6%, respectively. Conclusion The application of CT and face-neck joint field and reasonable increase of dose can improve the efficacy of NPC radiotherapy.