局部晚期口咽癌放射治疗分析

Radiotherapy for Locoregionally Advanced Carcinoma of the Oropharynx

目的探讨局部晚期口咽癌放射治疗方法疗效及放射毒副作用.方法回顾性分析我科1993年1月～1998年6月收治的局部晚期口咽癌192例,其中63例患者接受单纯常规外照射(CF);65例接受分段加速超分割放射治疗(S-AHF);64例接受常规外照射加同步化疗(CMT).结果全组病例1,3,5年生存率分别为65.1%(126/192),37.5%(72/192),33.9%(65/192)及无瘤生存率分别为43.2%(83/192),31.3%(60/192),28.6%(55/192);其中3组1,3,5年生存率无显著性差异(P=0.129)及1,3,5年无瘤生存率在统计学上差异有显著性(P=0.022).3组3级以上急性黏膜炎发生率分别为14.7%,40.3%和44%.结论在局部晚期口咽癌治疗中,常规外照射加同步化疗可提高无瘤生存率,并不提高总生存率,且急性毒副反应发生率明显增高.

Objectives To evaluate the therapeutic outcome and radioactive toxicity of locoregionally advanced oropharyngeal carcinoma treated by different approaches.Methods A retrospective study was done on 192 patients by three different ways of radiotherapy. 63 patients received conventional fractionated radiotherapy(CF) alone; 65 patients received split-course accelerated hyperfractionated radiotherapy(S-AHF); 64 patients received the combination treatment (CMT) which consisted of conventional fractionated radiotherapy and concomitant chemotherapy .Results The 1, 3, 5-year overall survival rates were (65.1%),(37.5%),(33.9%) and disease-free survival rates were (43.2%),(31.3%),(28.6%), respectively . The 1,3,5-year overall survival rates were found no significant difference among these three groups (P=(0.129)). The 1,3,5-year disease-free survival rates had significant difference among three groups (P=(0.022)). The incidences of grade 3+ acute muscositis in three groups were (14.7%),(40.3%) and 44%,respectively.Conclusion The combination of sinulliceous chemotherapy and radiotherapy would improve the disease-free survival rate and not increase overall survival rate in locoregionally advanced oropharyngeal carcinoma . Therefore it improved the incidence of acute local morbidity.