近距离腔内照射联合外照射治疗控制口腔癌术后复发的临床效果评价

Evaluation on the Clinical Efficacy of Intracavitary Brachytherapy Combined with External Beam Radiotherapy in Controlling Postoperative Recurrence of Oral Cancer

目的探讨近距离腔内照射联合外照射治疗控制口腔癌术后复发的临床疗效和应用价值。方法选取2003年3月至2013年3月于佛山市顺德区第一人民医院口腔科进行口腔癌术后复查并确诊为口腔癌复发的患者60例,采用随机数字表法分为两组：联合组（30例）给予60Coγ射线常规外照射加腔内补充照射,补充剂量参考点为黏膜下5 mm,每次10 Gy,2~3次,间隔3 d;常规组仅给予常规外照射。观察比较两组患者治疗前后病变部位变化、局部控制率、远处转移率等指标。结果联合组治疗后口腔癌术后复发患者局部病变明显改善,局部控制率高于常规组（P〈0.05）,两组间远处转移率比较差异无统计学意义（P〉0.05）。结论近距离腔内照射联合外照射治疗口腔癌术后复发,依托成熟的技术条件未引起严重的并发症,可显著改善患者局部病变情况,延长患者生存时间,提高生活质量。

Objective To explore clinical efficacy and value of intracavitary brachytherapy combined with external beam radiotherapy in controlling postoperative recurrence of oral cancer. Methods A total of60 patients diagnosed as postoperative recurrence of oral cancer in Department of Stomatology,Shunde First People＇s Hospital from Mar. 2003 to Mar. 2013 were divided into two groups according to random number table,with 30 cases in each group. Patients in the combined group were given60 Co γ conventional external beam radiotherapy and intracavitary radiotherapy as supplement,and supplement dose of reference point was5 mm submucosal,10 Gy per time,2-3 times,interval of 3 days. Patients in the conventional group received only conventional external beam radiotherapy. Lesion changes,local control rate and distant metastasis rate and other indicators of the two groups before and after the treatment were observed and compared. Results Intracavitary brachytherapy combined with external beam radiotherapy improved the local lesion and the local control rate in patients with recurrence of oral cancer（ P〈0. 05）. Distant metastasis rate of the two groups had no statistically significant difference（ P〉0. 05）. Conclusion Relying on mature technological conditions,intracavitary brachytherapy combined with external beam radiotherapy can significantly improve the local lesions,prolong the survival time,and improve the quality of life in patients with postoperative recurrence of oral cancer,without causing serious complications.