【摘要】 目的:比较超分割伴后程加速放疗和常规放疗治疗鼻咽癌的疗效和急性反应。方法: 1998年 3月至2001年 8月, 163例低分化鳞癌的住院鼻咽癌患者进行放射治疗。随机分组 81例入超分割伴后程加速组, 1. 2GyBid,间隔≥6小时,至 48Gy/40次既第 4周后,改为 1. 5GyBid达 6周总剂量 78Gy/60次。82例入常规放疗组,为7周 70Gy/35次。结果:中位随访期 37个月(19~59个月)。超分割后程伴加速组和常规组 2年和 4年的局部控制率分别为 94. 7%、87. 9%和 89. 9%、79. 2% (P=0. 1627 ); 2年和 4年的无瘤生存率分别为 81. 6%、71. 7%和83. 8%、64. 7% (P=0. 5438); 2年和 4年的总生存率分别为 95. 6%、88. 2%和 96. 2%、79. 2% (P=0. 5424)。Ⅲ度黏膜反应发生率分别为 42% 和 15. 9%,Ⅳ度黏膜反应的比例相仿(6% 和 5% )。结论:本研究发现在超分割基础上的后程加速超分割放疗与常规放疗相比有提高局控率的趋势,但生存率并未提高。急性粘膜反应较常规放疗有所增加。更多还原

【Abstract】 Purpose:To compare the treatment result and acu te toxicity of hyperfractionated radiation therapy with late course concomitant boost (HFLB) to conventional radiation regimen (CR). Methods:From March 1998 to August 2001, 163 patients with poorl y differentiated squamous cell carcinoma of nasopharynx were enrolled into this study. Eighty-one patients were randomized to HFLB group, being treated with 1. 2 Gy/F Bid (with interval of not less than 6 hours) to 48 Gy/40F/4weeks followed by 1.5 Gy/F Bid to a total dose of 78 Gy/60 F in 6 weeks. 82 patients received conventional radiotherapy (CR) with total dose of 70 Gy/35fractions in 7 weeks. Results:Median follow-up was 37 months (19-59 months). Two an d 4- year local control rates were 94.7%, 87.9% and 89.9%, 79.2% in HFLB group and CR group respectively (P= 0.1627 ); two and 4- year disease-free sur vival rates were 81.6%, 71.7% and 83.8%, 64.7% in HFLB group and CR group respec tively (P=0.5438); two and 4- year overall survival rate were 95.6%, 88.2% and 96.2%, 79.2% in HFLB group and CR group respectively (P=0.5424). Grade I II mucositis were more frequently observed in the HFLB group compared to the CR group(42% vs 15.9%), while the frequency of grade IV mucositis were similar (6% vs 5%). Conclusions:Compared to the conventional radiotherapy, the hype rfractionated radiotherapy with late course concomitant boost showed a trend tow ards a better local control rate with an increased severity of acute mucositis. The overall survival was similar in both groups.更多还原