【摘要】 目的对比分析常规分割与后程加速超分割放疗对鼻咽癌的远期疗效及不良反应。方法将108例鼻咽癌患者随机分为常规分割组53例,后程加速超分割组55例。两组均采用6MV X射线面颈联合野对穿照射,先用常规分割照射36～40 Gy,2 Gy/次,5次/周,3 5～4周完成。后改为小面颈野对穿避脊髓照射。常规分割组仍用常规分割照射总剂量至70 Gy 7周完成。后程加速超分割组采用加速超分割1.5 Gy/次,2次/d,间隔≥6 h,5 d/周,总剂量70 Gy 6周完成。结果 1、3、5年肿瘤局部控制率后程加速超分割组分别为95.3%、92.8%、85.5%,常规分割组分别为87.2%、72.6%、65.3%,两组差异有统计学意义(P<0.05)。1、3、5年生存率后程加速超分割组分别为97.8%、75.5%、67.2%,常规分割组分别为93.6%、72.1%、64.3%,两组差异无统计学意义(P>0.05)。鼻咽癌复发率明显低于常规分割组(P<0.05)。两组急性口腔黏膜反应及放射后遗症差异无统计学意义(P>0.05)。颈部淋巴结复发率及远处转移率差异无统计学意义(P>0.05)。远期毒副反应差异也无统计学意义(P>0.05)。结论后程加速超分割与常规分割相比,前者局部控制率明显提高,鼻咽癌部复发率降低,患者能耐受,不增加远期不良反应,但对颈部淋巴结复发率及远处转移率作用不明显。更多还原

【Abstract】 Objective To compare the long - term effects of conventional fractionation(CF) radiotherapy of nasopharyngeal carciooma(NPC),and factors influencing survival.Methods 108 NPC patients were randomly divided into LCAF and CF group,55 patients in the LCAF group and 53 patients in the CF group.The radiation beam used was 6 MV X -ray.Two large lateral opposing beams were first used for the treatment,and all the patients were irradiated 2.0 Gy one time,5 times a week,after the total dose was 36 -40 Gy,two small lateral opposing beams were uesd in order to shielded the spinal cord for all the patients.The patients in CFgroup were irradiated at 2 Gy once daily as before until) to accumulated total dose was 70 Gy.The patients in LCAF group were irradiated 1.5 Gy twice daily,with a minimum of six - hour interval in the late course.The accumulated total dose was 70 Gy.Results The First,third,fifth year local control rates were 95.3%, 92.8%,85.5%in LCAF group,and 87.2%,72.6%,64.2%in CFgroup.The difference between the two groups was significant (P <0.05).The First,third,fifth year survival rates were 97.8%,75.5%,67.2%in LCAF group,and 93.6%, 72.1%,64.3%in CF group.The difference between the two group was insignificant(P > 0.05 ).The neoplasm recurrence rate in LCAFgroup was significant reduced than CF group(P <0.05).There was no significant in the acute mucosal reasition and complications between in the two group(P > 0.05 ).Conclusion When compared with LCAF and Cfradiotherapy,the local control rate in LCAF group was higher than CF,and the neoplasm recurrence rate was lower than CF.This radiotherapy is tolerated and not increase the toxicity.But the recurrence rate of cervical lymph nodes and distant metastasis were similar between the two groups.更多还原