对局部顽固性鼻咽癌处理的研究(三)——加量照射随机分组研究结果

MANACMENT OF LOCAL RESIDUAL PRIMARY LESION OF NASOPHARYNGEAL CARCINOMA (NPC) - Ⅲ. Results of prospective randomized trial on booster dose

本文继本专题研究第一、二部分以后总结放疗D_T70Gy后鼻咽肉眼残存灶病理阳性者加量照射与否的随机分组研究结果,并与病理阴性组的预后作对比,进一步阐明对肉眼残存灶活检和加量照射的意义。

Seventy eight NPC patients with gross local residual primary lesions after having received 70 Gy to the nasopharynx were divided into two groups according to the result of biopsy: 1. Negative group 48 patients, and 2. Positive group 30 patients. The latter group was randomized into two subgroups, a. Positive observation group(POC)16 patients to whom no booster dose was added in addition to the 70 Cy already received, and b. Positive radiation group (PRG) 14 patients to whom booster dose was given on top of the 70 Cy a-lready received. The 5-year survival rate of PRG (75%) was higher than that of POG (32%) hut similar to that of NOG (58%) . Local recurrence rate was higher in POG (36%) than that of PRG (6%)but equal to that of NOG (4%) . The authors believe that biopsy is necessary for gross residual lesion in the nasopharynx and booster dose is beneficial for the positive ones. Factors of local recurrence in gross residual primary lesions are also discussed.