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目的探讨放射治疗联合鼻咽腔内后程热疗治疗鼻咽肿瘤在局部控制率以及近期疗效方面是否存在优越性。方法72例首次治疗的鼻咽癌患者随机分为治疗组35例,采用6Mv X线常规放射治疗加第3周起鼻咽腔内后程微波加热,每周1次,每例平均加热4次;对照组37例,采用6Mv X线单纯常规放射治疗。2组放射治疗剂量均为62-74 Gy／31-37 F,中位剂量68 Gy／34 F,2组一般资料具有可比性。结果治疗组鼻咽肿瘤完全缓解和部分缓解率分别为82．9％(29例)、14．3％(5例);对照组分别为59．4％(22例)(P<0．05)和29．8％(11例)(P>0．05)。咽旁间隙肿瘤CR率治疗组和对照组分别为84．0％(21／25)、64．0％(16／25),差异无统计学意义(P>0．05);降低了鼻咽腔内肿瘤完全消退时的肿瘤剂量;急性重度黏膜反应(3-4级)发生率治疗组较对照组高,但差异无统计学意义(P>0．05)。结论放射治疗联合鼻咽腔内后程热疗治疗鼻咽癌能被患者所耐受,能改善局部控制率,是否能改善咽旁间隙受侵肿瘤的局部控制率有待累积资料。
Objective To investigate the superiority of radiotherapy combined with nasopharyngeal endotemporal hyperthermia in the treatment of nasopharyngeal neoplasms in terms of local control rate and short-term curative effect. Methods 72 patients with nasopharyngeal carcinoma who were treated for the first time were randomly divided into treatment group (n = 35), routine radiotherapy with 6Mv X-ray and microwave heating in nasopharyngeal cavity after the third week, once a week for 4 times ; Control group of 37 cases, using 6Mv X-ray simple conventional radiotherapy. Radiotherapy dose of two groups were 62-74 Gy / 31-37 F, the median dose of 68 Gy / 34 F, two groups of general information is comparable. Results The complete remission rate and partial remission rate of nasopharyngeal tumor in treatment group were 82.9% (29 cases) and 14.3% (5 cases), respectively. The control group were 59.4% (22 cases) (P <0.05) ) And 29.8% (11 cases) (P> 0.05). The parapharyngeal space tumor CR rate in the treatment group and the control group were 84.0% (21/25) and 64.0% (16/25) respectively, with no significant difference (P> 0.05) The tumor dose when the tumor completely subsided; the incidence of acute severe mucosal reaction (Grade 3-4) was higher in the treatment group than in the control group, but the difference was not statistically significant (P> 0.05). Conclusion Radiotherapy combined with nasopharyngeal endovascular treatment of nasopharyngeal carcinoma patients can be tolerated by patients, can improve the local control rate, whether to improve the local control rate of parapharyngeal space invasion of tumor to be accumulated data.