鼻咽癌局部复发调强放疗的初步疗效观察  

Preliminary efficacy of intensity-modulated radiation therapy in locally recurrent nasopharyngeal carcinoma

作　　者：李子煌[1] 李先明[1] 吴冬[1] 杨东[1] 钟鹤立[1] 李壮玲[1] 

机构地区：[1]暨南大学第二临床医学院肿瘤放疗科,广东深圳518020

出　　处：《现代肿瘤医学》2007年第12期1761-1764,共4页Journal of Modern Oncology

基　　金：深圳市科技计划基金资助项目(编号:200405018)

摘　　要：目的:评价调强放疗(IMRT)在复发性鼻咽癌中应用的剂量分布、近期疗效及毒性反应。方法:2005年1月～2006年7月,12例经鼻咽部活检病理证实的复发性鼻咽癌患者采用全程IMRT,计划靶区(PTV)处方剂量为60Gy～76.44Gy(中位剂量69.72Gy),分次量1.87Gy～2.32Gy。结果:PTV的中位体积为145.55cm3,D95均值为59.5Gy,PTV接受的平均剂量及分次剂量均值分别为68.35Gy及2.13Gy;治疗结束时近期疗效为CR6例,PR4例,总有效率为83.3%。经3～17个月(中位10.5个月)随访,全部病例存活,1例出现鼻咽部再次复发,1例出现左颈部淋巴结复发,1例出现双颈、锁骨上淋巴结复发以及纵隔淋巴结、肝脏转移。治疗过程中除部分患者出现体重下降,轻度的口腔粘膜反应、粒细胞减少等,所有患者均能耐受治疗。结论:调强放疗在鼻咽癌放疗后局部复发患者中应用有较好的局控效果,能被患者耐受。Objective：To evaluate the physical dose distributions, immediate treatment responses and toxity in locally recurrent nasopharyngeal carcinoma （NPC） patients treated with intensity -modulated radiation therapy （ IMRT）. Methods： From Jannually 2005 to July 2006 , 12 locally recurrent NPC patients proven by histology were trea- ted by IMRT. Prescription dose was 60Gy -76.44Gy （ median dose 69.72Gy） in planning target volume （ PTV）, with the fractional dose of 1.87Gy - 2.32Gy. Results ： The median PTV was 145.55cm3 , the mean dose to 95 % of PTV was 59.8Gy , the mean and fractional dose of PTV were 68.35Gy and 2.13Gy, respectively. IMRT achieved the better immediate treatment responses in 10 patients with complete response in 6 cases and partial response in 4 cases, the response （ CR ＋ PR） rate was 83.3%. At median follow - up of 10.5 months （3-17months）, all patients were alive, local reeurrenee was found in one patient, one patient had local regional reeurrenee in neek lymph node, and one had loeal regional reeurrenee in neek and supra - elavieal lymph nodes, developed distant metastasis in mediastinal lymph nodes and liver. All patients tolerated this IMRT well, except for some patients with mild weight loss , mueositis in the oral eavity and granulopenia during IMRT. Conclusion ： Better preliminary effieaey treated with IMRT was aehieved in the patients with locally reeurrent nasopharyngeal eareinoma and all the patients tolerated this IMRT well.

关 键 词：复发性鼻咽癌 调强放疗 近期疗效 

分 类 号：R739.63[医药卫生—肿瘤]