本文選題：鼻咽癌 + 頸部淋巴結(jié)轉(zhuǎn)移　； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：背景:鼻咽癌是我國(guó)常見(jiàn)的頭頸部惡性腫瘤。因其特殊的解剖特點(diǎn)及對(duì)放射敏感的生物學(xué)特性，放射治療已經(jīng)成為其主要治療手段。如何在不降低療效的前提下減少放射治療對(duì)患者造成的副反應(yīng)及損傷，這個(gè)問(wèn)題成為了人們研究的熱點(diǎn)。盡量減小照射靶區(qū)是方法之一。在鼻咽癌病例中，，有20%~30%患者為頸淋巴結(jié)陰性，即N0期鼻咽癌患者。對(duì)于這部分患者的頸部預(yù)防性放療，我國(guó)臨床已達(dá)成僅行上半頸預(yù)防性照射的共識(shí)。 研究目的:通過(guò)薈萃分析以往研究中行上半頸和全頸放療的N0期鼻咽癌病例，比較其療效，再次驗(yàn)證頸淋巴結(jié)陰性鼻咽癌病例的頸部放療適宜范圍的選擇。 方法:從Pubmed、Embase、Cochrane和萬(wàn)方數(shù)據(jù)庫(kù)檢索出1990年1月至2013年6月期間公開(kāi)發(fā)表的相關(guān)文獻(xiàn)，制定文獻(xiàn)入組標(biāo)準(zhǔn)，篩選出符合入組標(biāo)準(zhǔn)的文獻(xiàn)，采用固定效應(yīng)模型對(duì)接受上頸和全頸放療病例的數(shù)據(jù)進(jìn)行比值比（OR）的綜合分析，分析指標(biāo)包括5年頸部局部控制率、頸部照射野內(nèi)局部控制率和頸部照射野外局部控制率。 結(jié)果:共有5篇文獻(xiàn)符合入組標(biāo)準(zhǔn)，均屬回顧性研究。5項(xiàng)研究共有1333例患者入組，其中970例接受上頸放療，363例接受全頸放療。上頸和全頸放療的病例之間的5年全頸部局部控制率、頸部照射野內(nèi)局部控制率和頸部照射野外局部控制率差異無(wú)統(tǒng)計(jì)學(xué)意義，OR值分別為0.89（95%CI：0.41～1.94）；1.29（95%CI：0.58～2.88）和0.42（95%CI：0.07～2.36）。 結(jié)論:頸部淋巴結(jié)陰性鼻咽癌頸部放療范圍選擇上頸部照射是合適的。
[Abstract]:Background: nasopharyngeal carcinoma (NPC) is a common malignant tumor of head and neck in China. Because of its special anatomical characteristics and radiosensitive biological characteristics, radiotherapy has become the main treatment method. How to reduce the side effects and injuries caused by radiotherapy without reducing the curative effect has become a hot topic. Minimizing the target area is one of the methods. 20% of NPC patients were neck lymph node negative, i.e. N 0 NPC patients. For this group of patients, we have reached a consensus that only upper half neck should be treated with prophylactic radiotherapy. Objective: to compare the efficacy of N0 stage nasopharyngeal carcinoma (NPC) treated with upper neck and full neck radiotherapy in previous studies, and to verify the choice of appropriate range of cervical radiotherapy for cervical lymph node negative nasopharyngeal carcinoma (NPC). Methods: the published literature was retrieved from the Pubmedus Embase Cochrane and Wanfang databases from January 1990 to June 2013. The fixed effect model was used to analyze the ratio of the data of upper neck and total neck radiotherapy. The analysis indexes included local control rate of neck in 5 years, local control rate in the field of neck irradiation and local control rate in field of irradiation of neck. Results: a total of 5 articles were in accordance with the admission criteria. All of them were included in a retrospective study of 5 items. 1333 patients were enrolled in the study. 970 of them received upper neck radiotherapy and 363 received total cervical radiotherapy. There was no significant difference in the local control rate between the upper neck and the whole neck radiotherapy, the local control rate in the field of neck irradiation and the local control rate in the field of neck irradiation. The OR values of the local control rates in the field of neck irradiation and in the field were 0.891.94 and 1.291.94 respectively, and the CIW of 0.4295 CI: 0.072.36, respectively. Conclusion: the range of cervical radiotherapy for cervical lymph node negative nasopharyngeal carcinoma is appropriate.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R739.63

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