论文部分内容阅读
目的观察顺铂(DDP)联合三维适形放疗(3DCRT)对局部复发上颌窦癌的放射增敏作用。方法66例复发者均为首程放疗后达其本痊愈或明显好转,一段时间(>8个月)后又出现鼻涕、鼻塞、疼痛、面部肿胀等情况恶化的临床症状,经病理检查确诊为复发,随机分为研究组和对照组,每组33例。研究组DDP20mg/m2用生理盐水250ml稀释后静脉滴注,滴注结束后50min内放疗,放疗均采用西门子直线加速器,6mV-X线,BrainLAB公司三维治疗计划系统行三维适形放疗(3DCRT)。3～5Gy/次,4～5次/周。照射剂量研究组45～50Gy、对照组55～60Gy。采用SCT和MRI比较两组近期疗效,并比较两组不良反应差别。结果研究组近期有效率(CR+PR)为73%,对照组为42%。两组不良反应发生率中白细胞下降,Ⅲ度以上口腔黏膜反应,脑水肿症状分别为24%(8/33)、3%(1/33)、24%(8/33)、和21%(7/33)、18%(6/33)、18%(6/33)(P<0.05)。结论DDP可增加局部复发上颌窦癌的放射敏感性,表现为在降低放疗剂量的情况下,提高了复发上颌窦癌的近期疗效且不增加不良反应。
Objective To observe the radiosensitization effect of cisplatin (DDP) and three-dimensional conformal radiotherapy (3DCRT) on the local recurrence of maxillary sinus cancer. Methods Sixty-six relapses were cured or markedly improved after the first course of radiotherapy. Clinical symptoms such as nasal discharge, nasal obstruction, pain and facial swelling appeared after a period of more than 8 months and were confirmed as recurrence by pathological examination , Were randomly divided into study group and control group, 33 cases in each group. The study group DDP20mg / m2 diluted with normal saline 250ml intravenous drip, radiotherapy within 50min after the end of infusion, radiotherapy using Siemens linear accelerator, 6mV-X line, BrainLAB 3D planning system for three-dimensional conformal radiotherapy (3DCRT. 3 ~ 5Gy / time, 4 ~ 5 times / week. The exposure dose was 45 ~ 50 Gy in the study group and 55 ~ 60 Gy in the control group. Short-term curative effect was compared between the two groups by SCT and MRI, and the differences of adverse reactions between the two groups were compared. Results The study group had an effective rate (CR + PR) of 73% and a control group of 42%. The incidences of leukopenia, grade Ⅲ or higher oral mucosal reactions and brain edema were 24% (8/33), 3% (1/33), 24% (8/33), and 21% 7/33), 18% (6/33), 18% (6/33) (P <0.05). Conclusions DDP can increase the radiosensitivity of locally recurred maxillary sinus cancer, which shows that it can improve the short-term curative effect of recurrent maxillary sinus cancer without increasing the adverse reaction when the dose of radiotherapy is decreased.