后程加速超分割放射治疗N_3期鼻咽癌(附30例临床分析)  

Treatment of Stage N_3 Nasopharyngeal Carcinoma with Late Course Accelerated Hyperfractionation Rationtherapy

作　　者：卢耀振[1] 黄显实[1] 农先胜[1] 林伟芬[1] 梁荣中[1] 黄任贵[1] 

机构地区：[1]广西民族医院肿瘤科,广西南宁530001

出　　处：《航空航天医学杂志》2009年第11期47-49,共3页Journal of Aerospace medicine

摘　　要：目的:探讨后程加速超分割放射治疗N3期鼻咽癌临床疗效。方法:60例N3期鼻咽癌患者随机分为后程加速超分割放射治疗组(LCAF组)30例,常规分割放射治疗组(CF组)30例。其中LCAF组先用常规分割照射,2.0 Gy/次,5次/周,放量达36~40 Gy后改用LCAF照射,1.5 Gy/次,2次/d,中间间隔6~8 h,每周放疗5 d,休息2 d,鼻咽癌放疗总量约68~76 Gy/6~6.5周,颈部放疗量为60~70 Gy/5.5~6周。CF组全部按常规分割放射治疗,鼻咽部放疗量为72~76 Gy/7~7.5 w,颈部放疗量为60~70 Gy/6~7 w。结果:鼻咽部肿瘤完全缓解率(CR)LCAF组和CF组分别为86.7%(26/30)、60%(18/30);颈部淋巴结完全缓解率(CR)LCAF组和CF组分别为90%(27/30)、56.6%(17/30),两组间比较有显著性意义(P【0.05)。1、3、5年生存率LCAF组分别为86.7%、73.3%、23.3%,CF组分别为80%、66.7%、20%,两组间差异无显著性意义(P】0.05)。鼻咽部5年局部控制率LCAF组为93.3%,CF组为80%;颈部淋巴结5年局部控制率LCAF组为86.7%,CF组为73.3%,两组间差异无显著性意义(P】0.05)。两组放疗毒副反应也无显著差异(P】0.05)。结论:后速加速超分割放射治疗N3期鼻咽癌较常规分割放射治疗具有更好近期疗效,但未能提高5年生存率及局部控制率,有必要扩大病例并作长期随访研究。Objective:To detect the clinical results of late course accelerated hyperfractionation(LCAF) radiotherapy in stage N3 nasopharyngeal carcinoma(NPC) patients.Methods:60 NPC patients in stage N3 were divided into conventionl(CF) and LCAF radiotherapy groups.Patients in CF group received conventional radiotherapy:the total dose of nasopharyngeal was 72~76 Gy in 7~7.5 w,and cervical lymphnode was 60~70 Gy in 6~7 w(2.0 Gy/f,5 f/w);Patients in LCAF group were treated with the same fractionation as CF group until the dose of 36~40 Gy,and then followed by LCAF radiotherapy :1.5 Gy/f,2 fractions a day with 6~8 hour interval between two fractions to the total dose of 68~76 Gy in nasopharyngeal and 60~70 Gy in cervical lymphnode.Results:The complete response rate in the nasopharyngeal was 86.7% in LCAF group and 60% in the CF group at the end of the course: the complete response rate in the in the cervical lymphnode was 90% in LCAF group and 56.6% in the CF group,with the different between the two groups significant(P<0.05).The1-,3-and 5-year survival rates were 86.7%、73.3%、23.3% in the LCAF group,and 80%、66.7%、 20% in CF group,there was not any significant difference between two groups(P>0.05).The 5-year local control rate of the nasopharyngeal was 93.3% in the LCAF group,and 80% in CF group;the rate of cervical lymphnode was 86.7% in LCAF group and 73.3% in the CF group,without finding any significant difference between two groups(P>0.05).There was no significant difference in radiation reaction between two groups(P>0.05).Conclusions:The LCAF radiotherapy can impove the preliminary results than conventional CF in stage N3 of NPC.But do not improve the survival rate and local control rates.It is worth further study.

关 键 词：N3期鼻咽癌 后程加速超分割 局部控制率 

分 类 号：R739.63[医药卫生—肿瘤]