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目的 评价鼻咽癌放射治疗后鼻咽部出血的发生率 ,正确施行分次立体定向放射治疗(FSRS)。方法 18例鼻咽癌常规放射治疗DT6 5～ 74Gy后 ,5例 (T4 期 )因肿瘤未控行FSRS加量照射2 4～ 40Gy ,6～ 8次完成 ;13例 (T2 ～T3期 )因肿瘤复发行第二程放射治疗 :A组 8例 ,常规放射治疗DT30～ 40Gy +FSRS 2 4～ 30Gy ,6～ 9次完成 ,B组 5例 ,单纯FSRS 40～ 42Gy ,6～ 8次完成。结果 T4 期肿瘤侵及颅底者出血发生率为 3/ 5 ;T2 ～T3期肿瘤复发第二程放射治疗 ,A组出血发生率为 1/ 8,B组为 1/ 5。结论 T4 期颅底明显破坏者FSRS加量治疗后出血发生率高 ;复发病例宜选择常规放射治疗+FSRS的综合方法 ,减少FSRS的总剂量和分次量
Objective To evaluate the incidence of nasopharyngeal hemorrhage after radiotherapy for nasopharyngeal carcinoma and to perform fractionated stereotactic radiotherapy (FSRS) correctly. Methods After 18 cases of conventional radiotherapy of nasopharyngeal carcinoma (DT6 5 ~ 74Gy), 5 cases (T4 stage) were treated with FSRS plus 24-4GG for 6 ~ 8 times and 13 cases (T2 ~ T3) Tumor recurrence in the second course of radiotherapy: A group of 8 patients, conventional radiotherapy DT30 ~ 40Gy + FSRS 24 ~ 30Gy, 6 to 9 times to complete, B group of 5 patients, simple FSRS 40 ~ 42Gy, 6 to 8 times to complete. Results The incidence of bleeding in stage T4 tumor invasion and skull base was 3/5. In stage T2 ~ T3, the tumor recurrence was radiotherapy in the second stage. The bleeding rate in group A was 1/8 and in group B was 1/5. Conclusions The incidence of hemorrhage after treatment with FSRS in T4 skull base was significantly higher. The recurrence patients should choose the combination of conventional radiation therapy and FSRS to reduce the total dose and fractionation of FSRS