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目的观察调强放疗与常规放疗治疗鼻咽癌的急性放射反应和临床疗效。方法筛选2012年6月—2014年11月72例在浙江省人民医院诊治的鼻咽癌患者,按照治疗方法将患者分为对照组和观察组,每组各36例,对照组接受常规放疗,观察组接受调强放疗,化疗方案均采用PF方案(顺铂30 mg/m~2,d_1~d_3;5Fu 500 mg/m~2,d_1~d_5),同步化疗和辅助化疗,放疗均为每天1次,5次/周,观察2组患者的急性放射反应和生存情况。结果观察组患者口干、吞咽疼痛、听力下降及皮肤损伤的发生率分别为63.9%、52.8%、38.9%、50.0%,对照组为94.4%、69.4%、52.8%、72.2%,观察组均明显低于对照组,差异具有统计学意义(χ~2=10.189、4.800、4.503、4.800,P<0.05);黏膜损伤方面,观察组发生率为75.0%,对照组为86.1%,观察组少于对照组,但差异无统计学意义(χ~2=3.192,P>0.05);截至2016年1月,观察组无局部复发患者,1例远处转移,无死亡病例;对照组有1例局部复发患者,2例远处转移,无死亡病例。结论调强放疗可有效地降低鼻咽癌患者放疗后的急性放射反应,有助于提高临床疗效及患者生存质量。
Objective To observe the acute radiation response and clinical efficacy of IMRT and conventional radiotherapy for nasopharyngeal carcinoma. Methods Screening 72 patients with nasopharyngeal carcinoma diagnosed and treated in Zhejiang Provincial People’s Hospital from June 2012 to November 2014 were divided into control group and observation group according to the treatment method, 36 cases in each group. The control group received routine radiotherapy, The patients in the observation group underwent IMRT. The chemotherapy regimen of PF treated with cisplatin (30 mg / m 2, d 1 ~ d 3, 5 Fu 500 mg / m 2, d 1 ~ d 5), concurrent chemotherapy and adjuvant chemotherapy were performed daily 1 time, 5 times / week, observed two groups of patients with acute radiation response and survival. Results The incidences of dry mouth, swallowing pain, hearing loss and skin lesions in the observation group were 63.9%, 52.8%, 38.9% and 50.0% respectively, and those in the control group were 94.4%, 69.4%, 52.8% and 72.2% Significantly lower than the control group, the difference was statistically significant (χ ~ 2 = 10.189,4.800,4.503,4.800, P <0.05); mucosal injury, the observation group was 75.0%, the control group was 86.1%, the observation group less In the control group, but the difference was not statistically significant (χ ~ 2 = 3.192, P> 0.05); as of January 2016, there was no local recurrence in the observation group, 1 case of distant metastasis and no death; in the control group, 1 case Local recurrence patients, 2 cases distant metastasis, no deaths. Conclusion IMRT can effectively reduce the acute radiation reaction after radiotherapy in patients with nasopharyngeal carcinoma, which can help to improve the clinical efficacy and quality of life of patients.