Cisplatin과 5-Flurouracil의 고용량유도항암요법후 방사선치료에 대한 비인강 악성종양의 치료성적과 예후인자의 분석

Background and Objectives: Nasopharyngeal carcinoma shows relatively poor prognosis due to the difficulty of early diagnosis, the tendency of metastasis, and high recurrence rate. The purpose of this study is to evaluate the survival rate of induction chemtherapy with cispatin + 5-Fu, and to analyze the prognostic factors of nasopharyngeal carcinoma. Material and Methods: The materials were forty nasopharyngeal carcinoma patients who treated with 3 courses of induction chemotherapy with Cisplatin (100 mg/m²) and 5-Fu (1000 mg/m²) and thereafter radiotherapy in Pusan National University Hospital from May, 1987 through December, 1996. We performed retrospective analysis about presumed prognostic factors such as sex, age, histopathologic types according to WHO classification, presence of metastatic cervical lymph node. We also compare AJCC and Ho staging systems to estimate the preferred relationship with prognosis. Results: The overall survival rates of 3-year and 5-year were 66.3% and 53.6%, respectively. Cervical lymph nodal metastasis had significant correlation with survival rate (p <0.05). However, there was no statistical significance of sex, age and histopathologic types with survival rate (p >0.05). AJCC and Ho classification also didn’t correlate with prognosis statistically in all stages. Conclusion: High dose induction chemotherapy with Cisplatin and 5-Fu and radiotherapy shows better 3-year and 5-year survival than other treatment modalities as reported in others. The prognosis of naso- pharngeal carcinoma have significant correlation with cervical lymph node metastasis at the time of diagnosis. We suggest the necessity of new staging system for the prediction of the prognosis of nasopharyngeal carcinoma. (J Clinical Otolaryngol 1999;10:244–249)