【摘要】 目的　探讨低熔点铅不规则挡块等中心治疗在鼻咽癌放疗中的价值。方法　 10 0例鼻咽癌随机分为常规挡块放疗组 (对照组 )和低熔点铅不规则挡块等中心放疗组 (实验组 ) ,两组均采用60 Coγ射线照射 ,鼻咽部原发灶总剂量 68～ 72Gy ,颈部淋巴结转移灶根治量 60～ 66Gy ,颈部预防量 5 0Gy。摄片法制作不规则挡块保护脑干、小脑、脊髓、眼睛、垂体等周围重要组织器官。早期放射反应按RTOG评分标准。结果　实验组鼻咽原发灶CR率 5 2 %明显高于对照组 3 2 % (P <0 .0 5 ) ,实验组口腔黏膜反应 ,牙龈酸痛、视力下降、胃肠道反应发生率均低于对照组 (P <0 .0 5 ) ,放射性皮肤反应、放射性咽炎、放射性中耳炎、口干发生率两组无显著性差异 (P >0 .0 5 )。结论　鼻咽癌放疗采用低熔点不规则挡块等中心照射新技术能提高鼻咽部原发灶局部控制率和有效保护周围的正常组织器官 ,减少周围正常组织和器官的损伤 ,提高患者生存质量 ,值得推广使用 ,远期疗效和后期放射性损伤有待进一步随访观察更多还原

【Abstract】 Objective To evaluate the radiotherapy effects on nasopharyngeal carcinoma with low-melting-point lead irregular shield technique. Methods From June 2001 to April 2003, 100 cases with nasopharyngeal carcinoma were randomly divided into the experimental group and the control group. Both of two groups received radiotherapy with 60Co γ-ray, a radical doses with 68-72Gy in the nasopharynx and 60-66Gy in the neck, a preventive dose with 50Gy in the neck, The RTOG rules were used to evaluate acute radiotherapy damage. Results The results that complete remission of primary lesion in the experimental group 52% is higher than that in control group.The difference of remission rate between the two groups was significant statistically (P<0.05). On the acute radiation induced reaction. The reaction of gastrointestinal and mucous of oral cavity, visual impairment was milder in the experimental group than that in the control group. There was significant difference statistically between the two groups (P<0.05). Conclusion The low-melting-point lead irregular shield technique for patient with nasopharyngeal carcinoma protected important organs, reduced the radiotherapy damage, the technique may elevate local control rate and life quality of patients with nasopharyngeal carcinoma.更多还原