论文部分内容阅读
目的探讨立体定向放射外科（ＳＲＳ）在鼻咽癌治疗中应用的可行性及价值。方法１９９６年８月至１９９７年１２月用Ｘ－刀治疗鼻咽癌１３例，其中初治者６例，复发者７例。初治者结合外照射７０～７５Ｇｙ，Ｘ－刀靶区周边剂量为１７～２２．５Ｇｙ（中位剂量１８Ｇｙ）。复发者中行外照射加Ｘ－刀３例，Ｘ－刀多次治疗４例，其中行２次者３例，４次者１例。靶区周边剂量为１８～３０Ｇｙ（中位剂量２４Ｇｙ）。结果初治者局控率为８３．３％（５／６）。复发者局控率为７１．４％（５／７）。初治者全部存活，中位生存期１１个月。复发者存活２例，死亡５例，中位生存期７个月。结论ＳＲＳ为提高鼻咽癌治疗的局控率，降低后期并发症发生率提供了安全有效的途径。确切评价ＳＲＳ在鼻咽癌治疗中的作用尚需累积更多的病例资料，进行较长期的观察研究。
Objective To investigate the feasibility and value of stereotactic radiosurgery (SRS) in the treatment of nasopharyngeal carcinoma. Methods From August 1996 to December 1997, 13 cases of nasopharyngeal carcinoma were treated with X-knife, of which 6 were newly diagnosed and 7 were recurrent. The initial treatment combined with external irradiation 70 ~ 75Gy, X-knife target peripheral dose of 17 ~ 22.5Gy (median dose of 18Gy). Recurrence of extra-corporeal radiation plus X-knife in 3 cases, X-knife multiple treatment in 4 cases, of which 2 cases in 3 cases, 4 cases in 1 case. Target peripheral dose of 18 ~ 30Gy (median dose of 24Gy). Results The initial control rate was 83.3% (5/6). The rate of recurrence was 71.4% (5/7). All those who were initially treated survived with a median survival of 11 months. Recurrence survived in 2 cases, 5 died, the median survival of 7 months. Conclusion SRS provides a safe and effective way to improve the control rate of nasopharyngeal carcinoma and reduce the incidence of late complications. The exact evaluation of the role of SRS in the treatment of nasopharyngeal carcinoma still need to accumulate more case data for longer-term observation.