鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应对比分析

A comparative study of the efficacy and toxicity of concurrent bolus chemoradiotherapy and conventional fractionated retroflex field concurrent chemoradiotherapy for nasopharyngeal carcinoma

目的对比分析鼻咽癌同步推量同步放化疗与常规分割后缩野同步放化疗的疗效及毒性反应。方法回顾性分析自2007年1月—2008年12月于我院接受同步放化疗后的90例鼻咽癌患者,其中同步推量组45例,常规分割后缩野组45例。对比分析两组患者的5年总生存率(Overall survival,OS)、无进展生存率(Progression free survival,PFS)、无局部区域复发生存率(Loco-regional recurrence-free survival,LRFS)以及毒性反应。结果同步推量组5年OS、PFS、LRFS分别为84.4%、75.6%、88.9%,常规分割后缩野组5年OS、PFS、LRFS分别为82.2%、71.1%、86.7%,两组OS、PFS、LRFS差异无统计学意义。常规分割后缩野组脑干、脊髓、腮腺放疗反应要轻于同步推量组。结论在调强放疗时代,应用同步推量同步放化疗和常规分割后缩野同步放化疗两种方式在预后方面无统计学差异,而常规分割后缩野组放疗毒性较轻。

Objective The efficacy and toxicity of concurrent chemoradiotherapy(CRT)with concurrent bolus and CRT with conventional fractionation and shrinking field for nasopharyngeal carcinoma(NPC)were compared.Methods A retrospective analysis was performed in 90 patients with NPC who received radiotherapy and chemotherapy in our hospital from January 2007 to December 2008.The 5-year overall survival(OS),progression free survival(PFS),local recurrence free survival(LRFS)and toxicity were compared between the two groups.Results The 5-year OS,PFS and LRFS of CRT with concurrent bolus group were 84.4%,75.6%and 88.9%,respectively,while those of CRT with conventional fractionated field group were 82.2%,71.1%and 86.7%,respectively.There were no differences of OS,PFS and LRFS between the CRT with concurrent bolus and conventional fractionated field groups.The radiation response of brainstem,spinal cord and parotid gland in the conventional fractionated field CRT group was lighter than that in the CRT with concurrent bolus group.Conclusion There is no significant difference in the prognosis between the CRT with concurrent bolus and conventional fractionated field groups in the ear of intensity modulated radiation therapy,but the toxicity of CRT with conventional fractionated field group is lighter.