摘要
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。
Objectives To evaluate the
feasibility and value of stereotactic radiosurgery in the treatment of nasopharyngeal carcinoma.
]Methods Thirteen patients with nasopharyngeal carcinoma were treated with linacbased
stereotactic radiosurgery (SRS) between August 1996 and December 1997. After or before doses
of 7075 Gy external irradiation, these previously untreated patients (6 cases) received SRS
boosts of 1722.5 Gy (mean 18 Gy) to the tumor margin. In the recurrent patients (7 cases), three
were treated with external irradiation and SRS, four underwent multiple SRS. Of the latter, three
were treated 2 fractions and one treated 4 fractions. Dose to the periphery of the tumor in
recurrent patients ranged from 1830 Gy (mean 24 Gy). Results Five of 6 previously untreated
patients were controled within the boost volume, one patient developed local recurrence 7
months after SRS. Three of 7 recurrent patients studied decreased in size, 2 unchanged, and 2
local failure. All previously untreated patients were a Radio therapylive, median survival after
SRS for these patients was 11 months. Median survival for recurrent patients was 7 months,
with 2 patients still living. Conclusions SRS can provide a safe and effective approach to
improve the local control and reduce the late complications. Longer followup and increased
clinical experience will be necessary to evaluate the overall role of SRS in nasopharyngeal
carcinoma.
出处
《中国肿瘤临床与康复》
1999年第2期43-45,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
鼻咽癌
立体定向
放射疗法
Nasopharyngeal carcinomaLinac-based stereotactic radiosurgery