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目的 评价后程加速超分割放射治疗鼻咽癌的疗效及毒副反应。方法 86例鼻咽癌患者分为后程加速超分割治疗 (LCAF)组和常规分割治疗 (CF)组。其中LCAF组 43例 ,先用常规分割照射 3 6～ 40Gy 18～ 2 0次 2 4～2 8天 ,2Gy天 ,5次 1周 ,再用LACF照射 3 5～ 40 .5Gy 2 6～ 3 2次 17～ 2 1天 ,2次 1天 1.2 5～ 1.3 5Gy 天 ,间隔 6小时以上 ,总照射量 75～ 76.5Gy 46～ 5 0分次 45～ 48天 ;CF组 43例 ,总照射量 70Gy 3 5分次 47～ 49天。结果 1-,3 -,5 -年肿瘤局部控制率LCAF组分别为 95 .3 0 % ,90 .1% 86.0 % ;CF组分别为 90 .7% ,72 .1% ,65 .1% (P <0 .0 5 )。两组差异有显著性。 1-,3 -,5 -年生存率LCAF组分别为 97.7% ,72 .1% ,5 3 .5 % ;CF组为 95 .3 % ,69.8% ,48.8%。两组差异无显著性意义 (P >0 .0 5 )。两组的急性反应 ,LACF组口腔粘膜反应与CF组无显著性差异 (P >0 .0 5 )。结论 鼻咽癌LACF组的局部控制率明显高于CF组 ,但长期生存率无明显差异。
Objective To evaluate the efficacy and toxicity of late-course accelerated hyperfraction radiotherapy for nasopharyngeal carcinoma. Methods Eighty-six patients with nasopharyngeal carcinoma were divided into two groups: LCAF group and CF group. Among them, 43 cases of LCAF group were divided into 3 groups: 40 Gy, 20 ~ 20 24 to 28 days, 2 days, 5 times, and then irradiated with LACF for 35 ~ 40 .5 Gy 2 6 ~ 3 2 Times from 17 days to 21 days, twice a day from 1.2 5 to 1.3 5 Gy days with an interval of more than 6 hours, with a total exposure of 75 to 76.5 Gy 46 to 50 minutes and 45 to 48 days. Forty CF patients received a total exposure of 70 Gy 3-5 minutes 47 to 49 days. Results The local control rates of LCAF were 95.3%, 90.1% and 86.0% respectively in 1-, 3-, and 5-year groups and 90.7%, 72.1% and 65.1% respectively in CF group P <0. 05). The difference between the two groups was significant. 1-, 3-, and 5-year survival rates were 97.7%, 72.1% and 53.5% in LCAF group and 95.3%, 69.8% and 48.8% in CF group. There was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups in the acute response and oral mucosal response in LACF group (P> 0.05). Conclusion The local control rate of nasopharyngeal carcinoma LACF group was significantly higher than that of CF group, but the long-term survival rate had no significant difference.