逐步递量加速超分割放射治疗局部晚期鼻咽癌  

Escalated hyperfractionated accelerated radiation therapy for regional advanced nasopharyngeal carcinoma

作　　者：赵充[1] 陈明[1] 吴少雄[1] 曾祥发 卢泰祥[1] 崔念基[1] 钱剑扬[1] 

机构地区：[1]中山医科大学肿瘤医院放疗科,广州510060

出　　处：《中国癌症杂志》2000年第5期408-410,共3页China Oncology

基　　金：中山医科大学"2 11"工程课题! (编号 :980 5 9)

摘　　要：目的 :研究逐步递量加速超分割放射治疗 (EHART)局部晚期鼻咽癌的近期疗效和急性反应。方法 :1999年 4月— 2 0 0 0年 2月 6 4例T3— 4N0 M0 、KPS 80的鼻咽癌患者进入本研究 ,并随机分为常规分割放疗 (CFRT)组和EHART组 ,每组各 32例 ;CFRT组采用 2Gy 次 ,5次 周的方法 ,鼻咽靶区中心总剂量 6 8— 76Gy,中位数 70Gy ,34—38次 ,7— 8周 ;上颈部剂量 46— 5 6Gy ,2 3— 2 8次 ,5— 6周 ;EHART组每次分割剂量逐周递增 ,1、2、3、4、5周的分割剂量分别为 1.2Gy、1.3Gy、1.4Gy、1.5Gy和 1.6Gy,每天 2次 ,两次间隔时间 >6小时 ,每周 5天 ,鼻咽靶区中心总剂量 6 9.2— 71.6Gy ,中位数 70Gy,99— 10 2次 ,5周 ;上颈部剂量 46 .5— 5 4Gy ,6 5— 80次 ,4周。设野采用面颈联合野或面颈联合野 +面颈分野 ,均使用铅模不规则射野技术照射 ;放射源为6 0 Coγ射线和直线加速器的 6MV— 8MV光子线和 8MeV— 10MeV电子射线。结果 :EHART组口咽、喉咽急性放射反应明显较CFRT组严重 (P <0 .0 5 ) ;EHART组和CFRT组原发灶CR、PR率分别为 6 1.2 9%、38.71%和 6 7.74%、32 .2 6 % (P =0 .46 6 ) ,两组差别无显著意义。结论 :EHART能为大多数患者耐受 ;采用EHART和CFRT的方法病人近期疗效无明显差别 ,需扩大病例继续研究 ;?Purpose:To study the immediate responses and acute side effect of escalated hyperfractionated accelerated radiation therapy (EHART) for regional advanced nasopharyngeal carcinoma(NPC). Methods:The sixty four cases of nasopharyneal carcinoma with stage T 3—4 N 0M 0 and KPS≥80 were treated form April.1999 to Febuary.2000. These patients were randomized into two groups: EHART and conventional fractionated radiation therapy (CFRT). Thirty two cases were assigned to each group:The CFRT group patients were treated by 2 Gy/fraction a day, 5 treatment days per week. The total doses of nasopharyngeal carcinoma and superior neck were 68—76 Gy and 46—56 Gy respectively. The EHART group patients were treated by escalated dose: 1.2 Gy, 1.3 Gy, 1.4 Gy, 1.5 Gy, 1.6 Gy,twice fractions daily (over 6 hours interval) were given from the 1st to 5th weeks respectively. The total doses of nasopharyneal carcinoma and superior neck were 69.2—71.6Gy, 46.5—54Gy respectively. The facio cervical field or facio cervical field combined lateral facial field and anterior cervical field with cerrobend blocking were used. Results:There were significant difference in acute responses of the pharynx and larynx between two groups ( P <0.05) . The complete response rate (CR) and partial response rate (PR) of two groups are 67.74%, 32.26% and 61.29%, 38.71% respectively ( P =0.466). Conclusions:EHART could be tolerated by most of the patients. The immediate response of tumor, the survival rate and late complications in long term are worthwhile of further study.

关 键 词：鼻咽肿瘤 放射疗法 超分割放射治疗 放射剂量 

分 类 号：R739.630.5[医药卫生—肿瘤] R730.55[医药卫生—临床医学]