两种非常规分割放疗治疗鼻咽癌的疗效分析——附前瞻性初期临床报道

Analysis of effect of two altered fractionated radiotherapy regimens on nasopharyngeal carcinoma

目的 :对比观察两种放疗方式治疗鼻咽癌的局控率及急性反应。方法 :6 0例N0 -2 患者随机分为两组 ,30例采用标准超分割 (HFR)方式放疗 ,总量DT 76 .8Gy;30例采用前后加速超分割 (AHFR)方式放疗 ,总量DT 72Gy。结果 :(1)两组的 2年总生存率为 88 33%。 2年无病生存率HFR和AHFR组分别为 86 6 7%和 83 33%。两组的局部控制率分别为 :HFR 96 6 7% ;AHFR93 33%。 (2 )AHFR组与HFR组的急性粘膜反应程度相似 ,AHRF组约低于HFR组 ,无显著性差异。 (3)放疗结束时局部肿瘤的近期消退率AHFR组低于HFR组 ,无显著性差异。半年时两者CT示消退率相同。结论 :AHFR组急性粘膜反应与HFR组相似 。

Objective:To compare and evaluate the tumor local control rate and the normal tissue acute radiation reaction of two radiation methods in nasopharyngeal carcinoma (NPC).Methods:60 NPC patients with N 0 2 were randomized into two groups.The patients in the first group were treated with standard hyperfractionated radiotherapy (HFR),the total dose DT 76.8Gy.The patients in the second group were treated with early and late course accelerated hyperfractionated radiotherapy (AHFR),the total dose DT 72Gy.Results:(1)The two year overall survival rate of the two groups was 88.33%.The two year diseasefree survival rate was 86.67% in the HFR group,83.33% in the AHFR group.The local control rate was 96.67% and 93.33% respectively.(2)The acute reaction of mucosa were slightly different in both groups( P > 0.5 ).(3)The initial tumor response rate at the end of radiation in the AHFR group was less than in the HFR group ( P >0.5).The tumor response evaluated by CT of both groups at half a year were the same.Conclusion:The acute oral mucosa reaction were slightly different in both groups.The long time results are to be evaluated by further investigation.