复发期鼻咽癌的再程治疗：调强放射治疗技术的实施及展望

Intensity-modulated radiation therapy in the treatment of locally recurrent nasopharyngeal carcinoma

外放射治疗是局部复发性鼻咽癌再程治疗的主要手段。不同的放疗技术,如常规放疗、立体定向放疗、近距离治疗、三维适形放疗、调强适形放疗各有其特点。调强适形放疗作为革命性的新技术,在复发鼻咽癌的治疗中发挥其独特的优势,既能提高肿瘤靶区的剂量同时又能减少鼻咽周围正常组织的照射剂量,从而提高治疗增益比,值得大力推广和应用。

Salvage surgery is the mainstay of treatment of early stage recurrent nasopharyngeal cancer（NPC）;however,radiation therapy is the only available modality for locally advanced recurrence.Different radiation technology,such as conventional radiotherapy,stereotactic radiotherapy,brachytherapy,three-dimensional conformal radiotherapy have been used for the purpose of salvage treatment after local recurrence in NPC and have produced various outcome.Full dose radiation therapy with or without chemotherapy may cause severe adverse effects especially in long-term survivors due to overdose of radiation to the regional critical organs.Intensity-modulate radiotherapy（IMRT） is the current standard for the initial definitive treatment of NPC.IMRT can differentiate the radiation dose to the normal tissue from tumor targets.However,its use in the treatment of locally recurrent NPC has not been sufficiently reported.The purpose of this report was to review the results of recurrent NPC treated by various radiation technologies,with a focus to the recently published literatures on IMRT for salvaging NPC local Failures.