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目的 探讨外照射加组织间插植超分割放射治疗口腔、口咽癌的疗效。方法 初治口腔、口咽癌 48例 ,外照射DT30～ 6 5Gy (T1 、T2 期 30～ 5 0Gy,T3 、T4期 5 0～ 6 5Gy) ,加1 92 Ir高剂量率组织间照射DT15～ 35Gy(T1 、T2 期 30～ 35Gy ,T3 、T4期 15～ 30Gy)。结果 原发灶全消率 :T1 期 5 5 ,T2 期 2 3 2 7,T3 期 6 13,T4期 0 3;部分消退率T2 期 4 2 7,T3 期 7 13,T4期 3 3。 3年总生存率和无瘤生存率分别为79 .4%和 5 5 .8%。影响预后的多因素分析结果显示仅与TNM分期、病理类型有关。结论 口腔、口咽癌外照射配合组织间插植近距离照射是早期病例的根治手段 ,对拒绝手术、有手术禁忌证和失去手术指征晚期患者是一种有效的姑息治疗手段
Objective To investigate the effect of external irradiation combined with tissue-grafted hyperfractionated radiotherapy on oral and oropharyngeal cancer. Methods Forty-eight cases of oral and oropharyngeal cancer were treated with external irradiation with DT30-65Gy (30-50Gy for T1, T2, 50-60T3, and T4). High-dose-rate interstitial irradiation with 1 92 Ir was used for DT15- 35Gy (30-35Gy in T1, T2, 15-30Gy in T3, T4). Results The total elimination rate of primary lesions was 5 5 in T1 phase, 2 3 2 in T2 phase, 7 3 in T3 phase, 0 3 in T4 phase, 4 2 in partial T2 phase, 7 7 in T3 phase and 3 3 in T4 phase. The 3-year overall survival and disease-free survival rates were 79.4% and 55.8%, respectively. The multivariate analysis of outcomes revealed that the results were only related to TNM stage and pathological type. Conclusion Oral and oropharyngeal cancer external irradiation combined with interplanting and planting brachytherapy is a radical method for early cases. It is an effective palliative treatment for advanced patients who refuse surgery, have surgical contraindications and lose surgical indications.