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目的研究鼻咽癌后程加速超分割放疗对鼻咽局部控制、生存的影响和并发症状况。方法全组178例鼻咽癌患者于1995年12月至1998年4月行首次单纯放疗,鼻咽原发灶采用~(60)Coγ线或6 MV X线外照射,其中前4周采用超分割1．2Gy/次,2次/d,5d/周,间隔≥6h,剂量为48Gy分40次；后2周采用加速超分割1．5Gy/次,2次/d,间隔≥6h,5d/周,剂量为30Gy分20次,全疗程的总剂量为78Gy分60次6周完成。结果急性黏膜反应中鼻咽黏膜反应0级仪2例,1级43例,2级78例,3级52例,4级3例。鼻咽5年局部控制率为87．7%,颈部5年局部控制率为85．7%。5年生存率为67．9%。5年远处转移率为26．1%,颅神经损伤占9．0%。结论该方法患者能耐受,5年局部控制率、生存率比常规分割和超分割有所提高,颅神经等晚期放射性损伤未见明显增加。
Objective To investigate the effect of nasopharyngeal hyperfractionated radiotherapy on local control and survival of nasopharynx and its complications after nasopharyngeal carcinoma. Methods A total of 178 patients with nasopharyngeal carcinoma (NPC) underwent radiotherapy for the first time from December 1995 to April 1998. Primary nasopharyngeal carcinoma was irradiated with ~ (60) Coγ ray or 6 MV X-ray. The first 4 weeks Divided by 1.2Gy / time, 2 times / d, 5d / week, interval≥6h, dose 48Gy 40 times; after 2 weeks accelerated hyperfractionation 1.5Gy / time, 2 times / d, / Week, the dose is 30Gy points 20 times, the total dose of the whole course of treatment is 78Gy 60 times 6 weeks to complete. Results In the acute mucosal reaction, nasopharyngeal mucosa reaction was performed on 0 scale in 2 cases, with grade 1 in 43 cases, grade 2 in 78 cases, grade 3 in 52 cases and grade 4 in 3 cases. Nasopharyngeal 5-year local control rate was 87.7%, neck 5-year local control rate was 85.7%. The 5-year survival rate was 67.9%. Five years distant metastasis rate was 26.1%, cranial nerve injury accounted for 9.0%. Conclusions The method can tolerate patients with local 5-year control and survival rate increased compared with conventional segmentation and hyperfractionation. There is no significant increase in advanced radioactive injury such as cranial nerves.