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目的:观察鼻咽癌后程加速超分割放射治疗(LCAF)的近期疗效和毒性反应。方法:60例鼻咽癌患者随机分为常规分割放射治疗(CF)组和LCAF组,CF组患者鼻咽部和颈部全程行常规分割放疗,LCAF组先常规放疗36 Gy,25 d,然后采用LCAF照射33～35 Gy,16～18 d,每日2次,间隔时间6 h,鼻咽部剂量为65～75Gy。有颈部淋巴结转移者颈部照射剂量68～74 Gy,无颈部淋巴结转移者预防照射剂量55～60 Gy。放射治疗结束时、放疗结束后3个月复查鼻咽部CT、纤维鼻咽镜、颈部CT和／或B超检查,综合评价放疗疗效。结果:放疗结束后 3个月LCAF组肿瘤全部消退率为79．31％,CF组为54．84％,差异有统计学意义(χ2=4．038 0,P<0．05),LCAF 组与CF组比较,Ⅰ、Ⅱ、Ⅲ度急性放射反应发生率差异无统计学意义(χ2=0．202 0,P>0．05)。结论:LCAF放射治疗可以改善中晚期鼻咽癌的局部控制率,而不增加急性放射反应。
Objective: To observe the short-term curative effect and toxicity of late course accelerated hyperfractionation radiation therapy (LCAF) for nasopharyngeal carcinoma. Methods: Sixty patients with nasopharyngeal carcinoma were randomly divided into routine radiotherapy (CF) group and LCAF group. Patients in CF group received routine radiotherapy for nasopharynx and neck. The LCAF group received routine radiotherapy 36 Gy and 25 d Using LCAF irradiation 33 ~ 35 Gy, 16 ~ 18 d, 2 times a day, interval 6 h, nasopharyngeal dose of 65 ~ 75Gy. Cervical lymph node metastasis with a dose of 68 ~ 74 Gy neck neck, neck lymph node metastasis prevention dose of 55 ~ 60 Gy. Radiotherapy at the end of 3 months after the end of radiotherapy review of nasopharynx CT, fiber nasopharyngeal, neck CT and / or B-ultrasound, a comprehensive evaluation of the efficacy of radiotherapy. Results: At 3 months after the end of radiotherapy, LCAF group showed a complete regression rate of 79.31% in tumor group and 54.84% in CF group (χ2 = 4.038 0, P <0.05), LCAF group Compared with CF group, there was no significant difference in the incidence of acute radiation reactions between Ⅰ, Ⅱ and Ⅲ degrees (χ2 = 0.202 0, P> 0.05). Conclusion: LCAF radiotherapy can improve the local control rate of advanced nasopharyngeal carcinoma without increasing the acute radiation reaction.