鼻咽癌后程超分割放疗的疗效分析  

The Analysis of Late-course Hyperfractionation Radiotherapy for Nasopharyngeal Carcinoma

作　　者：肖锋[1] 席许平[1] 刘雯[1] 廖遇平[1] 

机构地区：[1]湖南省肿瘤医院放疗科,长沙410013

出　　处：《肿瘤预防与治疗》2008年第2期158-161,共4页Journal of Cancer Control And Treatment

摘　　要：目的:观察鼻咽癌后程超分割放疗的疗效及毒副反应。方法:120例鼻咽癌患者随机分为后程超分割治疗组(后超组)和常规分割对照组(常规组)各60例。均先行面颈联合野常规分割对穿照射DT36Gy/20次/4周后,后超组:缩野后改用超分割照射,每次DT1.15 Gy^1.2Gy,2次/天,两次放疗间隔时间为6小时~8小时,每周照射5天,鼻咽病灶总DT74.8Gy^76.7Gy/54次/7.5周;对照组60例缩野后常规外照射,DT2.0Gy/次/天,鼻咽病灶总DT69~72Gy/37~38次/7.5周。颈部均为常规照射。结果:后程超分割组和常规组鼻咽部肿瘤完全消退率分别为98.3%、96.6%(χ2=3.85,P>0.05);1、3、5年肿瘤局部控制率分别为100%、94.86%、81.36%和100%、93.22%、62.21%(χ2=12.04,P<0.001);1、3、5年的生存率分别为100%、90%、74.61%和100%、78.94%、58.8%(χ2=5.71,P<0.01);两组差异有统计学意义。鼻咽癌后程超分割的局部控制率及长期生存率明显高于常规组,二组放射治疗急性毒副反应,后超组口腔黏膜反应与常规组差异无统计学意义(P>0.05)。复发与转移:常规组放疗后复发(41.6%)高于后超组(16.6%),两组间比较有统计学差异(χ2=9.076,P<0.01)。常规组放疗后(23.33%)出现转移高于后超组(13.33%),但两组间比较无统计学差异(χ2=2.04,P>0.05)。结论:鼻咽癌后程超分割治疗急性毒性放疗反应无明显加重,患者能耐受,疗效优于常规放射治疗。Objective： To evaluate the clinical efficacy and side reaction results of late-course hyperfractionation radiotherapy for nasopharyngeal carcinoma. Methods. 120 patients with NPC were divided into conventional fractionation group and Late-course hyperfrac- tionation radiotherapy group randomely. 60 patients in Late-course hyperfractionation radiotherapy group were treated with conventional face-neck joint portal until the dose to 36Gy/20f in 4 weeks first, and then received hyperfractionation radiotherapy： 1.15-1.2Gy/f, twice daily with 6-8 hours interval between the two fractions, to the total dose of 74.2-76.7Gy in 7.5 weeks. 60 patients in conventional fraetionation group received conventional radiotherapy： 2.0Gy/f, 5 fractions a week to a total dose of 69Gy-72Gy in 7.5 weeks. Results：The regression rates in the nasopharynx were 98.3% in the late-course hyperfractionation radiotherapy group and 96.6% in the conventional fractionation group after 6 months of radiotherapy respectively. The 1,3, and 5-year local control rates and survival rates in late-course hyperfractionation radiotherapy group were 100%, 94.86%, 81.36% and 100%, 90%, 74.61%, respectively. And those in conventional fractionation group were 100%, 93.22%, 62.21% and 100%, 78.94%, 58.8%, respectively. There was significant difference between the two groups（ P 〈0.01 ）. On the Contrary, no significant difference in acute mucnsitis or late complications was found between the two groups（P 〉 0.05）. For NPC the local control rate and survival rate of late-course hyperfractionation radiotherapy are higher than those of conventional fractionation. Recurrence rate of conventional fractionation is higher than that of late-course hyperfractionation radiotherapy. While there is no significant difference in the distant metastasis rates between the two groups. Conclusion：Late-course hyper- fractionation radio-therapy is superior to conventional fractionation radiotherapy.

关 键 词：鼻咽肿瘤 放射疗法 副反应 预后 

分 类 号：R739.63[医药卫生—肿瘤] R730.55[医药卫生—临床医学]