鼻咽癌放射治疗后残存/复发行立体定向照射后鼻咽部出血  

Nasopharyngeal hemorrhage after radiotherapy of nasopharyngeal carcinoma

作　　者：崔书祥[1] 王迎选[1] 北京 

机构地区：[1]中国人民解放军总医院放射治疗科,北京100853

出　　处：《中华放射肿瘤学杂志》2001年第3期180-182,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　评价鼻咽癌放射治疗后鼻咽部出血的发生率 ,正确施行分次立体定向放射治疗(FSRS)。方法　 18例鼻咽癌常规放射治疗DT6 5～ 74Gy后 ,5例 (T4 期 )因肿瘤未控行FSRS加量照射2 4～ 40Gy ,6～ 8次完成 ;13例 (T2 ～T3期 )因肿瘤复发行第二程放射治疗 :A组 8例 ,常规放射治疗DT30～ 40Gy +FSRS 2 4～ 30Gy ,6～ 9次完成 ,B组 5例 ,单纯FSRS 40～ 42Gy ,6～ 8次完成。结果　T4 期肿瘤侵及颅底者出血发生率为 3/ 5 ;T2 ～T3期肿瘤复发第二程放射治疗 ,A组出血发生率为 1/ 8,B组为 1/ 5。结论　T4 期颅底明显破坏者FSRS加量治疗后出血发生率高 ;复发病例宜选择常规放射治疗+FSRS的综合方法 。Objective To evaluate the incidence of nasopharyngeal hemorrhage after radiotherapy of nasopharyngeal carcinoma (NPC) in order to adjust adequately the dose of fractionated stereotactic radiosurgery (FSRS). Methods Eighteen NPC patients were treated by FSRS following conventional radiotherapy of D T65～74?Gy. Of them, 5 patients (T 4) with uncontrolled lesions received a boost dose of 24～40?Gy/6～8 f and 13 patients (T 2～3 ) with local recurrence received their second course of treatment with different regimens. Group A: 8 patients received routine radiotherapy 30～40?Gy followed by FSRS 24～30?Gy/6～9 f; Group B: 5 patients received FSRS 40～42?Gy/6～8 f alone. Results The frequency of nasopharyngeal hemorrhage was 3/5 for skull base invasion (T 4 ) lesions. The incidence of morbidity for re radiation after local recurrence of T 2～3 tumor was 1/8 in Group A and 1/5 in Group B.Conclusions The frequency of nasopharyngeal hemorrhage is high in skull base invasion by NPC (T 4).Therefore the dose of FSRS combined with conventional radiotherapy should be limited when re treating local recurrence of NPC.

关 键 词：鼻咽肿瘤 放射治疗 立体定向放射治疗 出血 

分 类 号：R739.63[医药卫生—肿瘤] R730.155[医药卫生—临床医学]