目的　通过我院鼻咽癌放疗后 5年随访的 177例患者中 43例远处转移的病人临床资料分析 ,希望从中找出规律 ,尽可能地降低远处转移的发生。方法　自 1988年至 1992年期间 ,我院收治的鼻咽癌有随访记录的 177例中 ,发现远处转移 43例 ,全部病例均经病理证实。全部病例以 6 MV直线加速器外照射 ,鼻咽部原发灶根治剂量 68～76GY ,颈部淋巴结转移灶先以X线切线野照射 40GY后 ,再垂直电子线照射 2 0G。结果　远处转移多于一年内高发 ;2～ 3年缓慢下降 ;3年后趋于稳定。T1～T2 期 ;骨、肺、肝转移排列基本一样。T3 ～T4 期 ;骨转移最多。病期越晚 ,远处转移发生的百分率越高。转移与各年龄组无明显相关性。随着N分期的增加 ,远处转移明显增高。结论　从远处转移发生的时间看三年内为高发 ,一年之内最多 ,三年后基本稳定。转移部位排列为骨、肺、肝。T1～T2 期骨、肺、肝的转移无明显差异 ;T3 ～T4 期则以骨转移最多。病期的早晚与远处转移有关 ;说明越是晚期治疗的难度越大。年龄与远处转移的关系不明显 ;颈部淋巴结的大小、多少与远处转移有关。在鼻咽癌放疗的根治措施上根据T与N的不同分期 ,制定不同的综合治疗方案应是今后值得探索的 Objective To analyze the clinical data of 43 patients with distant metastasis in 177 patients with 5-year follow-up after 5 years of radiotherapy of nasopharyngeal carcinoma in our hospital, hoping to find out the law and reduce the distant metastasis as much as possible. Methods From 1988 to 1992, our hospital treated nasopharyngeal carcinoma with follow-up records of 177 cases, found that distant metastasis in 43 cases, all cases were pathologically confirmed. All the cases were irradiated with 6 MV linear accelerator. The radical dose of nasopharyngeal primary tumor ranged from 68 to 76 Gy. The neck lymph node metastasis was irradiated with 40 Gy first in the X-ray tangent field and then 20 Gy with the vertical electron beam. Results distant metastasis more than a year high incidence; 2 to 3 years decreased slowly; 3 years later stabilized. T1 ~ T2 period; bone, lung, liver metastases arranged basically the same. T3 ~ T4 period; the most bone metastases. The later the disease, the higher the percentage of distant metastases. No significant correlation between metastasis and age groups. With the increase of N staging, distant metastasis was significantly increased. Conclusions The time from distant metastasis is high in three years, the highest in one year and the most stable in three years. Metastatic sites arranged as bone, lung, liver. There was no significant difference in the metastasis of bone, lung and liver between T1 and T2, and the most bone metastases from T3 to T4. The sooner or later period of disease is related to distant metastasis; the more difficult the late treatment is, the more it is. The relationship between age and distant metastasis is not obvious; the size of cervical lymph nodes, how much and distant metastasis. In the radical radiotherapy of nasopharyngeal carcinoma on the basis of different stages of T and N, to develop a different comprehensive treatment plan should be worth exploring in the future