毫米波联合放射治疗晚期复发的头颈部鳞癌

Millimeter-wave irradiation in combination with radiotherapy for treatment of late stage of recurrent squamous cell carcinoma of head and neck region

目的 评价毫米波联合放射治疗晚期复发的头颈部鳞癌的疗效。方法 1997年 1月～ 2 0 0 0年 12月对 40例患者行毫米波联合放射治疗 (联合组 ) ,3 6例患者仅接受放射治疗 (单放组 )。两组患者放疗40～ 72 .1Gy(平均 5 9Gy) ,联合组加毫米波治疗 2 0～ 3 8次 (平均 3 1次 )。两组 76例患者共有 97只复发瘤行疗后疗效评价。结果 疗后患者全身情况和Karnofsky评分 :联合组显著优于单放组 (P <0 .0 5 )。肿瘤治疗有效率 (CR +PR) :联合组 78% (3 9/5 0 )、单放组 5 7.4% (2 7/4 7) ,组间差异有显著 (P <0 .0 5 )。其它明显影响疗效的因素有放疗高剂量 (>5 4Gy)和瘤径 (≤ 4cm )。生存率 :联合组 1、2、3年生存率分别为 65 %、3 2 .5 %、7.5 % ,单放组为 47.2 %、2 2 .2 %、5 .6%。

Objective To evaluate the therapeutic effect of millimeter wave irradiation and radiotherapy in the treatment of late stage of recurrent squamous cell carcinoma of head and neck region. Methods From January 1997 to December 2000, 76 patients with 97 tumors were enrolled in this study, among them 40 patients accepted the treatment of millimeter wave irradiation and radiotherapy(combined group),and 36 patients accepted the radiotherapy only(RT group). The dose given during the radiotherapy was 40～72.1Gy(with a mean of 59Gy). The patients in the combined group received the millimeter wave irradiation for 20～38 times(with a mean of 31). Results General condition and Karnofsky score of the patients after the treatment were much better in combined group than that of the RT group( P < 0.05 ).The tumor regression rate (CR+PR) were 78% (39/50)and 57.4% (27/47), respectively, in combined group and RT group( P <0.05). Other factors which were considered referable to therapeutic effect include the high radiation dose(>54Gy) and diameter of the tumor (≤4cm).The 1 ,2 and 3 year survival rates were 65%,32.5%, and 7.5%,respectively in combined group, and 47.5%,22.2% and 5.6%,respectively in RT group. Conclusion Millimeter wave in combination with radiotherapy can obviously improve the curative effect for treatment of late stage of recurrent squamous cell carcinoma of head and neck region.