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目的目前,调强放射治疗技术已被广泛应用于鼻咽癌的治疗中,本研究旨在探讨同步推量调强放射治疗与传统调强放疗治疗在鼻咽癌患者的近期和远期治疗效果。方法选取2008-04-12-2010-07-01山东省肿瘤医院收住的鼻咽癌患者102例,根据放疗方式不同分为研究组(50例)和对照组(52例)。研究组采用同步推量调强放疗,对照组采用传统调强放疗,比较两组的近期有效率、毒副作用和远期疗效。结果两组总有效率分别为90.0%(45/50)和86.5%(45/52);其近期疗效差异无统计学意义,χ~2=0.022,P=0.882;研究组和对照组3~4级口腔黏膜急性毒副作用分别为54.0%和55.8%(P=0.858),面颈部皮肤反应分别为4.0%和11.5%(P=0.245);两组5年无进展生存率、总生存率分别为76.0%和69.2%(χ~2=1.14,P=0.286)和84.0%、82.7%(χ~2=0.031,P=0.859)。结论与传统调强放疗相比,同步推量调强放疗在鼻咽癌近期和远期疗效及副作用方面的效果相似,两者差异无统计学意义。
Objectives At present, the intensity modulated radiation therapy has been widely used in the treatment of nasopharyngeal carcinoma. The purpose of this study is to investigate the short-term and long-term therapeutic effects of concurrent push-volume IMRT and conventional intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma. Methods Totally 102 patients with nasopharyngeal carcinoma admitted to Cancer Hospital of Shandong Province were divided into study group (50 cases) and control group (52 cases) according to different radiotherapy methods. The study group used synchronous thrust intensity modulated radiotherapy and the control group received conventional intensity modulated radiotherapy. The recent efficiency, side effects and long-term efficacy of the two groups were compared. Results The total effective rates were 90.0% (45/50) and 86.5% (45/52) respectively in the two groups. There was no significant difference in the curative effect between the two groups (χ ~ 2 = 0.022, P = 0.882) Grade 4 oral mucosal acute toxicities were 54.0% and 55.8%, respectively (P = 0.858), and skin and neck reactions were 4.0% and 11.5% respectively (P = 0.245). The 5-year progression-free survival and overall survival rates 76.0% and 69.2% (χ ~ 2 = 1.14, P = 0.286) and 84.0% and 82.7% (χ ~ 2 = 0.031, P = 0.859, respectively). Conclusions Compared with traditional intensity modulated radiotherapy, the effect of synchronous push metrorrower therapy in the treatment of nasopharyngeal carcinoma in the short and long term is similar to that of side effects. There is no significant difference between the two methods.