80例鼻咽癌应用新型施源器腔内后装治疗的疗效分析

Effectiveness of Intracavitary Afterloading Therapy Using A New Type of Applicator for 80 Cases with Nasopharyngeal Carcinoma

目的:探讨鼻咽癌外照射联合新型施源器后装治疗与单纯外照射的疗效和并发症。方法:将80例初治鼻咽癌患者按治疗方法分为外照射联合腔内后装(综合治疗组)及单纯外照射(对照组)两组,综合治疗组外照射剂量DT60～65Gy,腔内后装在外照射后期进行,剂量DT6～20Gy,中位剂量12Gy。对照组外照射剂量DT70～75Gy。结果:全部病例随访至2006年5月,随访率97.5%,综合治疗组和对照组的近期有效率分别为92.5%、75.3%(P<0.05),3、5年生存率分别为87.5%、65.0%(P<0.05)及74.2%、55.6%(P>0.05);3、5年无瘤生存率分别为72.5%、60.0%及64.5%、52.8%(P>0.05)。两组并发症发生率有显著性差异。结论:鼻咽癌外照射联合新型施源器后装治疗提高肿瘤近期有效率和3、5年生存率,降低口咽干燥等放疗并发症发生,提高生活质量。

Objective： To evaluate the effectiveness and complications of treatment with externalbeam radiotherapy （EBR） plus intraeavitary aflerloading therapy （IAT） using a new type of applicator and to compare it to EBR alone for treatment of nasopharyngeal carcinoma （NPC）. Methods： Eighty NPC patients receiving initial treatment were divided into two groups according to the method of treatment, i.e. EBR plus IAT in the combined therapy group and EBR alone in the control group （n=40）. The dose of external irradiation for the combined therapy group was 60-65 Gy. The IAT was performed after EBR, with a total dose of 6 to 20 Gy and a median of 12 Gy. Patients in the control group received doses ranging from 70 to 75 Gy. Results： A total of 97.5% of the patients were followed up by May 2006. The overall response rate （ORR） of the combined therapy group and the control group was 92.5% and 75.3% respectively （P〈0.05）. The 3 and 5-year survival rates of the two groups were 87.5%, 65.0% （P〈0.05） and, 74.2% and 55.6% （P〉0.05）. The 3 and 5-year disease-free survivals of the two were 72.5%, 60.0% and, 64.5% and 52.8%, respectively （P〉0.05）. There was a significant difference between the two groups in the rate of complications. Conclusions： External irradiation plus intracavitary brachytherapy, using a new type of applicator, may improve the ORR and survival rate, reduce radiation complications and improve quality of life.