鼻咽癌后程加速超分割放射治疗的疗效观察  

作　　者：李金伟 王蓉[2] 肖海[2] 吴伟 张群贵 

机构地区：[1]赣州市肿瘤医院放疗科,江西341000 [2]赣南医学院

出　　处：《当代医学》2014年第18期1-2,共2页Contemporary Medicine

基　　金：江西省卫生厅2011年度科技计划项目基金资助(20113190)

摘　　要：目的：观察鼻咽癌后程加速超分割的近期疗效。方法选取120例局部晚期鼻咽癌患者，随机分为后程加速超分割组（研究组）和常规分割组（对照组）（n=60），2组均行同期顺铂化疗。2组开始均常规分割，50 Gy/25次后，研究组鼻咽每天照射2次，每次1.5 Gy，颈部CTV 1（Clinic Target Volume 1）上午照射1.8～2.0 Gy，GTVnd（Gross Tumour Volume nord）下午照射1.0～1.2 Gy，间隔6 h以上，鼻咽总剂量71～73 Gy，颈部CTV 1至59～60.8 Gy，GTVnd至65～68 Gy；对照组鼻咽及颈部仍常规分割，鼻咽剂量70～74 Gy，CTV 1至60 Gy，GTVnd至66～68 Gy。结果研究组、对照组放疗结束时、放疗后3、6个月鼻咽控制率分别为91.7%、95.0%、96.7%及78.3%、80.0%、83.3%（P＜0.05），颈部控制率分别为93.3%、96.7%、98.3%及80.0%、86.7%、86.7%。（P＜0.05）。研究组耳及口咽黏膜2、3级急性放射损伤增加较明显（50%vs 30%及53%vs 35%，均P＜0.05），但均能耐受。结论后程加速超分割并同期化疗能提高局部晚期鼻咽癌的原发灶及颈部淋巴结局控率，耐受性好。Objective To observe the recent effect and complications for locally terminal nasopharyngeal carcinoma（NPC）with the method of the late course accelerated hyperfraction joint concurrent chemotherapy. Methods 120 cases who were locally terminal with NPC were divided into the late course accelerated hyperfraction（Study group）and conventional fraction（Control group）,60 cases in each group,each case was irradiated conventional fraction initially,after 50 Gy/25 f,The nasopharygeal of the study group was irradiated 2 times per day with 1.5 Gy,The positive area of cervical lymph nodes area（CTV 1）were irradiated with 1.8-2.0 Gy in morning,the lymph nodesof positive （GTVnd） were irradiated with 1.0-1.2 Gy at afternoon,interval of more than 6 hours,with the total doses of nasopharygeal were 71-73 Gy,the total doses of CTV1 were 59-60.8 Gy, GTVnd were 65-68 Gy;The nasopharygeal and the cervix of the control group were irradiated with the conventional method,The nasopharygeal were irradiated to 70-74 Gy,CTV 1 to 60 Gy,GTVnd to 66-68 Gy. All patients during radiotherapy underwent concurrent cisplatin chemotherapy. Results The nasopharygeal control rates of the study group and the control group were 91.7%,95.0%,96.7%and 78.3%,80.0%,83.3%（P〈0.05）at the end of radiotherapy and 3 months later and 6 months later respectively,The neck control rates of the two groups were 93.3%,96.7%,98.3%and 80.0%,86.7%,86.7%（P〈0.05）respectively.The incidences and degrees of the acute radiation injury of the ears and the oropharynx mucous membranes increased significantly（P〈0.05）, but all can tolerate. Conclusion The method of the late course accelerated hyperfraction joint concurrent chemotherapy can improve the control rate of the local terminal nasopharyngeal primary tumor and the cervical lymph node ,and the patient’s tolerance is good.

关 键 词：鼻咽癌 放射治疗 分次剂量 同期化疗 近期疗效 

分 类 号：R739.63[医药卫生—肿瘤]