鼻咽癌低氧放疗的临床观察  

Clinical Observation of Hypoxic Rad iotherapy for Nasopharyngeal Carcinoma

作　　者：夏火生[1] 韩守云[1] 李苹[1] 刘志晨[1] 唐平元[1] 

机构地区：[1]解放军第三零九医院放疗科,北京100091

出　　处：《癌症》2003年第7期745-748,共4页Chinese Journal of Cancer

摘　　要：背景与目的:近年来国内肿瘤低氧放疗的临床应用开展很快。低氧对正常组织放射保护作用已被证实,但它是否对肿瘤也存在保护作用尚无肯定答案。本研究比较鼻咽癌患者常规放疗和低氧放疗的临床结果,并加以分析。方法:收集1992年3月至2000年6月间在我院接受低氧放疗或常规放疗的117例鼻咽癌病例。其中Ⅰ期11例、Ⅱ期30例、Ⅲ期57例、Ⅳ期19例。低氧组69例接受低氧放疗,常规组48例接受常规放疗。两组患者年龄、性别、TNM分期、病理分类、辅助治疗等均无显著性差异(P>0.05)。全部病例均应用6MVX线和8～12MeV电子线照射,鼻咽部剂量72Gy(68～82Gy),颈部转移淋巴结剂量64Gy(60～70Gy)。结果:2～3级急性口咽粘膜、唾液腺损伤和2～3级晚期口干症在低氧组的发生率分别为23.2%、26.1%和37.7%,在常规组分别为77.1%、62.5%和91.7%(P≤0.01)。肿瘤局部复发、颈淋巴结复发转移和远处转移率在低氧组分别为14.5%、23.2%和21.7%,常规组分别为12.5%、20.8%和18.8%(P>0.05)。低氧组1、3、5、7年生存率分别为97.1%、83.7%、74.4%和54.5%,常规组分别为97.9%、86.8%、70.2%、54.7%(P>0.05)。结论:低氧能减轻放射治疗引起的不良反应,降低并发症发生率;初步观察低氧放疗后肿瘤复发、转移及患者生存情况与常规放疗无明显差异,但仍需?BACKGROUND &OBJECTIVE:The clinical application of hypoxic radiotherapy (RT)was developed at a hig h speed in China in recent years.The protective effect of hypo xic RT on normal tissues has been proved.However,there was not an affirmativ e answer whether hypoxic RT had any protective effect on tumor.This stu dy was desig ned to analyze this quest ion by comparing clinical results of hypoxic RT with reg ular RT in nasopharyng e al carcinoma (NPC)patients.METHODS :A series of 117patients with NPC who underwent hypoxic RT or reg ular RT be tween March 1992and June 2000in PLA309Hospital was enrolled.The cancers were stag ed as Ⅰ,Ⅱ,Ⅲ,andⅣin 11,30,57,and 19cases ,respectively.Of these,69received hypoxic RT,and 48received reg ular RT.There was no sig nificant difference in ag e,sex,TNM stag ing ,patholog ical type,adjuva nt therapy between two g roups (P>0.05).All patients underwent 6MV X-ray and8-12MeV electronic beam.The nasopharyng eal areas received dose of 72Gy (rang e,68to 82Gy ),and neck positive lymph node reg ions receive d dose of 64Gy (rang e,60to 70Gy ).RESULTS :The incidence rates of 2-3deg ree ear ly irradiation toxicity of oropharynx mucous membrane,saliva ry g land,andⅡ-Ⅲdeg ree late dry mouth were 23.2%,26.1%,37.7%in hyp oxic RT g roup and 77.1%,62.5%,91.7%in reg ular RT g roup,res pectively(P≤0.01).The incidence rates of local recurrence,neck recurrence and metastasis ,distance met astasis were 14.5%,23.2%,21.7%in hypoxic R T g roup and 12.5%,20.8%,18.8%in reg ular RT g roup,respectiv ely(P>0.05).The 1-,3-,5-,7-year survival rates were 97.1%,83.7%,74.4%,54.5%in hypoxic RT g roup and97.9%,86.8%,70.2%,54.7%in reg ula r RT g roup,respectively(P>0.05).CONCLUSION:Hypoxia could alleviate irradiatio n toxicity and reduce complication rate of NPC patients.T here is no sig nificant difference be tween hypoxic RT and reg ular RT in tumor recurrence and metastasis and the survi val rate of NPC.Further study is needed.

关 键 词：鼻咽癌 低氧 放疗 临床观察 

分 类 号：R739.63[医药卫生—肿瘤]