外照射及高剂量率腔内后装治疗早期鼻咽癌的疗效及生存率的影响  

EFFECT OF EXTERNAL RADIATION PLUS INTRACAVITARY AFTERLOADING TGHERAPY OF HIGH-DOSE RATE TO EFFICACY AND SURVIVAL RATE FOR EARLY STAGE NASOPHARYNGEAL CARCINOMA

作　　者：袁君[1] 章正[1] 申良方[1] 

机构地区：[1]中南大学湘雅医院,长沙410008

出　　处：《中国现代医学杂志》2003年第14期74-76,共3页China Journal of Modern Medicine

摘　　要：目的 :探讨外照射加高剂量率腔内后装 (腔内后装 )与单纯外照射治疗早期鼻咽癌的疗效及放射损伤发生率。方法 :将 5 6例Ⅰ、Ⅱ期鼻咽癌患者随机分为外照射加腔内后装 (综合治疗组 )及单纯外照射 (对照组 )两组 ,前者鼻咽部外照射剂量DT5 6～ 6 0Gy ,腔内后装在放疗结束前 2周进行 ,每周 1次 ,每次 8Gy ,总剂量16Gy ;后者外照射剂量DT6 8～ 72Gy。结果 :综合治疗组及对照组肿瘤局部控制率分别为 76 .7%及 73.1% (P>0 .0 5 ) ;综合治疗组和对照组 5及 7年生存率分别是 73.3%、6 3.3%及 76 .9%、6 1.5 % (P >0 .0 5 ) ;张口困难(门齿距 <3cm)发生率综合治疗组和对照组分别为 6 .7%及 2 6 .9% ,前者明显低于后者 ,差别具有显著性 (P<0 .0 5 )。结论 :虽然综合治疗组及对照组的肿瘤局部控制率比较无明显差异 ,但是综合治疗可以降低外照射剂量 ,减少放射损伤 ,提高患者放射治疗的生活质量。Objective:To compare the efficacy and the incidence rate of radiation damage between external radiation plus intracavitary afterloading therapy of high-dose rate and external radiation alone for early stage nasopharyngeal carcinoma patients.Methods:56 nasopharyngeal carcinoma patients of stage I and II were randomized into two groups: combined external radiation and intracavitary after loading therapy (combination radiotherapy group) and external beam therapyalone (control group). In combination radiotherapy group, patients received external beam for 56-60 Cry, followed by intracavitary afterloading therapy of 16Gy /2 fractions/2 win the last two weeks of the course; In control group, patients received external beam for 68～72Gy.Results:Local control rates of the two groups were 76.7% and 73.1% (P>0.05) respectively, 5-year and 8-year survival rates were 73.3%, 63.3% and 76.9/6, 61.50/6 ( P > 0.05) respectively; the combination radiotherapy groug had lower trismus than the control group (6.7% versus26.9%, P< 0.05 ). Conclusions:There was no statistical difference between local control rate of combination radiotherapy group and control group, but combination radiotherapy can reduce the external irradiation dose and radiation damage and can improve the quality of life.

关 键 词：鼻咽肿瘤 癌 放射疗法 近距离治疗 

分 类 号：R739[医药卫生—肿瘤]