鼻咽癌常规放疗与调强放疗的临床研究  

Conventional radiotherapy and intensity-modulated radiotherapy for nasopharyngeal carcinoma

作　　者：孙久波 郝俊芳[1] 杨新华[1] 于水[1] 董伟[1] 李一明 王兴莉[1] 

机构地区：[1]山东省肿瘤防治研究院放疗五病区,山东济南250117

出　　处：《中华肿瘤防治杂志》2012年第19期1495-1498,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:比较鼻咽癌不同放疗方式的远期并发症发生情况及远期疗效。方法:采用门诊随访、电话随访、随访信等方式,调查2003-01-01-2006-07-31在我院行放射治疗的145例鼻咽癌患者临床资料,分析不同放疗方式远期并发症发生率及远期疗效。其中常规放疗68例,调强放疗77例。随访的远期并发症包括口干、张口受限、放射性龋齿、听力下降、颈部纤维化等。所有的远期并发症均视为二分类变量。结果:常规放疗组和调强放疗组口干、颈部纤维化的发生率分别为94.1%和61.0%(χ2=22.012,P<0.01)、41.2%和15.6%(χ2=11.839,P=0.001),张口受限、放射性龋齿、听力下降的发生率分别为35.3%和26.0%(χ2=1.484,P=0.223)、35.3%和28.6%(χ2=0.753,P=0.385)、52.9%和40.0%,χ2=2.846,P=0.092。常规放疗组和调强放疗组5年生存率分别为60.5%和77.4%,χ2=4.320,P=0.038。结论:鼻咽癌调强放疗远期并发症的发生率低于常规放疗,远期疗效明显优于常规放疗,但调强放疗仍存在部分远期并发症,影响患者的生存质量。OBJECTIVE:To compare the incidence of late complications and treatment results between conventional radiotherapy and intensity-modulated radiotherapy of nasopharyngeal cancer.METHODS: From January 1,2003 to July 31,2006,a total of 145 patients treated with radical radiotherapy were studied retrospectively.The clinical materials and information of imaging were collected.All patients were restaged according to the 2002 UICC staging system of nasopharyngeal carcinoma.Sixty-eight patient were treated with conventional radiotherapy,77 with intensity-modulated radiotherapy.The late complications were assembled as two categorical variables.RESULTS:Compared with the control group,the incidence of xerostomia and neck fibrosis were significantly lower in the IMRT group(61.0% vs 94.1%,χ2=22.012,P<0.01;15.6% vs 41.2%,χ2=11.839,P=0.001).Although the incidence of trismus,dental caries,and hearing loss were lower in the IMRT group,but they did not reach statistical difference(26.0% vs 35.3%,χ2=1.484,P=0.223),(28.6% vs 35.3%,χ2=0.753,P=0.385),(40.0% vs 52.9%,χ2=2.846,P=0.092).The 5-year overall survival rates were 77.4% in the IMRT group and 60.5% in the conventional radiotherapy group(χ2=4.320,P=0.038).CONCLUSIONS: The IMRT showed survival benefits and good normal tissue protection for nasopharyngeal carcinoma patients,but the incidence of late complications are also high.Doctors need to be aware of these complications in order to prevent serious ones and to improve the patients' quality of life in the long term.

关 键 词：鼻咽肿瘤 放射治疗 治疗结果 副反应 

分 类 号：R739.63[医药卫生—肿瘤]