鼻咽癌常规和超分割后加速放疗的疗效分析  

Efficacy of conventional radiotherapy and late course accelerated hyperfractionationated radiotherapy for nasopharyngeal carcinoma

作　　者：何霞云[1] 郭小毛[1] 章真[1] 叶明[1] 潘自强[1] 何少琴[1] 刘泰福[1] 

机构地区：[1]复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华放射医学与防护杂志》2013年第4期392-395,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 比较鼻咽癌常规和超分割后加速放疗的局部控制率和生存率.方法 200例初治鼻咽癌患者根据计算机产生的随机数人常规组和超分割后加速放疗组,鼻咽原发灶采用60Coγ射线或6MVX射线外照射,常规组70 Gy/35次/7周,超分割后加速放疗组前4周采用超分割1.2 Gy/次,剂量为48 Gy/40次,后2周加速超分割1.5 Gy/次,剂量为30 Gy/20次,均为2次/d,间隔≥6 h,5 d/周.结果 常规组99例中,远处转移25例、鼻咽复发25例、颈部复发16例；超分割后加速放疗组101例中,远处转移18例、鼻咽复发16例、颈部复发13例.常规组和超分割后加速组5年鼻咽局部控制率分别为75.9％、87.6％（x2=4.066,P＜0.05）,总生存率分别为58.0％、74.1％（x2=5.076,P＜0.05）,5年无远处转移率分别为74.1％、83.3％ （P ＞0.05）,颈部局部控制率分别为81.5％、90.0％ （P ＞0.05）.结论 与常规分割相比,超分割后加速放疗组提高了鼻咽局部控制率和总生存率,未减少颈部复发和远处转移率.Objective To compare the efficacy after conventional radiotherapy and late course accelerated fractionation radiotherapy for nasopharyngeal carcinoma （NPC）.Methods A total of 200 NPC patients were enrolled and randomly assigned to conventional radiotherapy （CF） group with 99 cases or late course accelerated fractionation radiotherapy （LCAF） group with 101 cases,who received irradiation to 60Co γ or 6 MV X-rays.In the CF group,the total dose of nasopharynx was 70 Gy/35 fractions at 2 Gy daily.In the LCAF group,for the first two-thirds of the treatment,two daily fractions of 1.2 Gy were given to the primary lesion and the total dose was 48 Gy/40 fractions.For the last one third of the treatment,the dose per fraction was increased to 1.5 Gy and the total dose was 30 Gy/20 fractions.Results There were 25,16,25 in CF group and 16,13,18 patients in LCAF group who had recurrence of nasophaynx,cervical lymph nodes,and distant metastasis,respectively.The 5-year nasopharyngeal control and overall survival rates was 75.9% and 87.6% in CFgroup （x2 =4.066,P〈0.05）,58.0% and 74.1%（x2 =5.076,P 〈 0.05） in LCAF group,respectively.Cervical lymph nodes local rates and distant metastasesfree rates at 5 years were 8 1.5% and 90.0% in CF group （P 〉 0.05）,74.1% and 83.3% （P 〉 0.05） in LCAF group,respectively.Conclusions Compared with CF,LCAF can improve nasopharyngeal control and overall survival rates,but there are no significant difference in the recurrence rates of cervical lymph nodes and distant metastasis.

关 键 词：鼻咽肿瘤 常规分割 超分割后加速放疗 局部控制率 

分 类 号：R73[医药卫生—肿瘤]