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目的 :探讨加速分割放射治疗鼻咽癌的治疗效果、放射反应和并发症。方法 :研究1993年 6月— 1996年 6月经病理证实首程接受加速分割放疗的 16 8例鼻咽癌患者的局部复发率、 5年生存率、放射反应及并发症 ,并与同期接受常规分割放疗的 170例鼻咽癌患者进行对比研究。加速分割组 (研究组 )每周照射 6天 ,每天 1次 ,每次 185 c Gy～ 190 c Gy,总剂量 740 0 c Gy～ 76 0 0 c Gy/39f～ 41f,共 46天～ 48天 ,常规分割组 (对照组 )每周照射 5天 ,每天 1次 ,每次 2 0 0 c Gy,总剂量 70 0 0 c Gy～ 75 0 0 c Gy,预防剂量 5 0 0 0 c Gy～ 5 5 0 0 c Gy。结果 :随访超过 5年 ,研究组与对照组的局部复发率分别为 13.7% (2 3/16 8)和 2 6 .5 % (45 /170 ) (P<0 .0 1) ,5年生存率分别为 5 9.5 % (10 0 /16 8)和 48.8% (83/170 ) (P<0 .0 5 )。 度急性放射反应分别为 48.8% (82 /16 8)和 33.5 % (5 7/170 )(P<0 .0 1) ,并发症发生率研究组明显低于对照组。结论 :加速分割放射治疗鼻咽癌的疗效优于常规放射治疗 ,患者能耐受加速分割放射治疗方案。
Objective: To investigate the treatment effect, radiation response and complications of accelerated fractionated radiation therapy for nasopharyngeal carcinoma. Methods: The local recurrence rate, 5-year survival rate, radiation response and complications of 16 8 nasopharyngeal carcinoma patients who underwent accelerated radiotherapy for the first time confirmed by pathology from June 1993 to June 1996 were studied and compared with the same period Radiotherapy 170 cases of nasopharyngeal carcinoma patients were compared. The accelerated division group (study group) received weekly irradiation of 6 days, 185 c Gy to 190 c Gy per day, and a total dose of 740 c ces to 76 c 0 c Gy / 39 f to 41 f for 46 days to 48 days , The conventional group (control group) was irradiated 5 days a week, once a day for 200 c Gy, with a total dose of 700 c Gy to 75 c c, and a preventive dose of 500 c Gy ~ 5 5 0 0 c Gy. Results: After 5 years of follow-up, the local recurrence rates of the study group and the control group were 13.7% (2 3/16 8) and 26.5% (45/170) respectively (P <0.01), and 5-year survival Rates were 5 9.5% (100/168) and 48.8% (83/170), respectively (P <0.05). Degree of acute radiation reaction were 48.8% (82/168) and 33.5% (57/170) respectively (P <0.01). The incidence of complications was significantly lower in the study group than in the control group. Conclusion: Accelerated fractionated radiotherapy of nasopharyngeal carcinoma is superior to conventional radiotherapy, and patients can tolerate accelerated fractionated radiotherapy.