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目的总结解放军总医院螺旋断层放疗鼻咽癌的2年临床经验及近期结果。方法 2007年9月-2009年9月间收治73例初治鼻咽癌患者,其中单纯放疗24例,同步综合治疗49例。处方剂量:原发灶及转移淋巴结计划靶区70-74Gy/33F,高危计划靶区60-62.7Gy/33F,低危计划靶区52-56Gy/33F。根据RTOG/EORTC标准评价急性反应。结果平均出束治疗时间为468.8s。放疗急性反应发生率:皮肤0级2.7%,1级76.7%,2级13.8%,3级6.8%;口腔黏膜0级1.4%,1级32.9%,2级60.2%,3级5.5%;口干0级4.0%,1级45.3%,2级50.7%。口干症随时间逐渐缓解,至放疗结束后1年无≥2级口干。同步化疗显著增加了急性反应。放疗结束1月时,鼻咽原发病灶及颈部转移性淋巴结消退率分别为91.8%和98.1%。中位随访时间14.8个月。2例患者放疗结束后肿瘤局部复发,2例患者出现远处转移。1年无复发生存率、无远处转移生存率及总生存率分别为95.6%、97.2%和94.8%。结论鼻咽癌螺旋断层放疗是一种高效、安全、有效的治疗方式。
Objective To summarize the 2-year clinical experience and recent results of radiofrequency radiation therapy of nasopharyngeal carcinoma in PLA General Hospital. Methods From September 2007 to September 2009, 73 patients with newly diagnosed nasopharyngeal carcinoma were treated, including 24 cases of radiotherapy alone and 49 cases of concurrent treatment. Prescription dose: 70-74Gy / 33F target area of primary tumor and metastatic lymph node, 60-62.7Gy / 33F target area of high risk and 52-56Gy / 33F target area of low risk. Acute reactions were evaluated according to RTOG / EORTC criteria. Results The average treatment time for the beam was 468.8s. The incidence of acute response to radiotherapy was 2.7% in grade 0, 76.7% in grade 1, 13.8% in grade 2 and 6.8% in grade 3; 1.4% in grade 0, 32.9% in grade 1, 60.2% in grade 2 and 5.5% in grade 3; Level 0 4.0%, Level 1 45.3%, Level 2 50.7%. Dry mouth disease gradually eased over time, to 1 year after radiotherapy no grade 2 dry mouth. Simultaneous chemotherapy significantly increased the acute response. At 1 month after radiotherapy, the regression rates of primary nasopharyngeal lesions and neck metastatic lymph nodes were 91.8% and 98.1%, respectively. The median follow-up time was 14.8 months. Two patients had local tumor recurrence after radiotherapy and two patients had distant metastasis. The 1-year recurrence-free survival rate, distant metastasis-free survival rate and overall survival rate were 95.6%, 97.2% and 94.8% respectively. Conclusion The spiral CT radiotherapy of nasopharyngeal carcinoma is an effective, safe and effective treatment.