影响早期声门型喉癌局部控制率的因素分析

The Factors Influencing Local Control Rate of Early Glottic Cancer

目的 了解放疗的分割剂量、疗程时间等因素对早期声门型喉癌局部控制率的影响。方法 对 61例早期声门型喉癌行根治性放疗 ,放射野采用二相对野 ,射线为60 Coγ线或 6MVX线 ,所有患者每日照射 1次 ,每周 5次 ,分割剂量为 1.48～ 1.96Gy ,其中 1.48～ 1.60Gy 11例 ,1.61～ 1.79Gy 3 2例 ,1.80～ 1.96Gy 18例 ,疗程为 49～ 78天。 结果 T1期和T2 期的 5年局部控制率分别为 77.14 %和 5 7.69%。分割剂量分别为 1.48～ 1.60Gy、1.61～ 1.79Gy、1.80～ 1.96Gy者的 5年局部控制率分别是2 7.2 7%、75 .0 0 %、83 .3 3 % ,3组比较有非常显著性差异 (P <0 .0 1)。疗程时间≤ 60天、 >60天者的 5年局部控制率分别为70 .96%、66.67% ,疗程时间短者的局部控制率明显高于疗程时间长者 (P <0 .0 1)。结论 放疗是T1～T2 期声门型喉癌的有效治疗方法 ,分割剂量、疗程时间是影响局部控制率的重要因素 ,分割剂量低。

Objective To study the influence of fraction size,overall time,and other factors in radiotherapy on early glottic cancer.Methods 61 patients with T 1～T 2 early glottic cancer were treated with radical radiotherapy .Treatment was delivered one fraction every day,5 fraction/week.The fraction size was 1.48～1.96 Gy,1.48～1.60 Gy in 11 cases,1.61～1.79 Gy in 32,≥ 1.80 Gy in 18,overall time ranged from 49 to 78 days.Results 5 year local control rate was 77.14% for T 1 and 57.69% for T 2.Patients,treated with fraction size of 1.48～1.60 Gy,had 5 year local control rate of 27.27%,while those receiving 1.61～1.79 Gy,≥1.80 Gy had 5 year local control rate of 75.00%,83.33%( P <0.01).5 year local control rate was 70.96% for overall time ≤60 days, 66.67% for overall time >60 days( P <0.01).Conclusion Radiotherapy was an effective method forT 1～T 2 glottic cancer,Fraction size ?overall time were significantly correlated with local control rate.For early glottic cancer,local control rate decreased with smaller fraction size and prolonged overall time.