鼻咽癌调强放疗的临床疗效观察

Intensity-moudulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma

目的探讨调强放疗治疗鼻咽癌的疗效和毒副反应。方法 383例鼻咽癌患者分为调强放疗组(131例)和常规放疗组(252例),分别接受调强放疗和常规放疗。结果调强放疗组1、3、5 a局部控制率分别为100.0%、93.1%、91.6%,1、3、5 a生存率分别为98.5%、87.8%、74.8%;常规放疗组分别为97.6%、82.9%、78.2%和95.2%、71.4%、61.5%,其中调强放疗组3、5 a局部控制率及生存率均明显高于常规放疗组(P<0.05)。调强放疗组口干、张口受限、听力下降、颈部组织纤维化和放射性脑病发生率均低于常规放疗组(P<0.05)。结论调强放疗技术能最大限度提高鼻咽癌的肿瘤控制率和降低周围正常组织的照射剂量,从而改善鼻咽癌患者的生存状况,值得推广应用。

Objective To investigate the efficacy and toxicities of intensity-moudulated radiotherapy in the treatment of nasopharyngeal carcinoma. Methods All the 383 patients with nasopharyngeal carcinoma were divided into two groups, 131 patients of the intensity-moudulated radiotherapy group received the intensity-moudulated radiotherapy, and 252 patients of the conventional radiotherapy group received the conventional radiotherapy. Results In the intensity-moudulated radiotherapy group, 1 -, 3-, 5-year local control rates were 100.0 %, 93.1%, 91.6 % ; 1 -, 3-, 5- year survival rates were 98.5 % , 87.8 % ,74.8 %. In the conventional radiotherapy group, 1 -,3-,5-year local control rates were 97.6% ,82.9% ,78.2% ; 1-,3-,5-year survival rates were 95.2% ,71.4% ,61.5%. The 3-,5-year local control rates and survival rates in the intensity-moudulated radiotherapy group were higher than those in the conventional radiotherapy group （ P 〈 0.05 ）. The dry mouth,limited mouth, hearing loss, neck tissue fibrosis and radiation encephalopathy incidences in the intensity-moudulated radiotherapy were lower than those in the conventional radiotherapy group （ P 〈 0.05 ）. Conclusion For the nasopharyngeal carcinoma, intensity-moudulated radiotherapy can improve the tumor local control rate and decrease the surrounding normal tissue radiation, and improve the survival and quality of life of patients with nasopharyngeal carcinoma.