后程加速超分割治疗鼻咽癌的临床分析

Clinical analysis of late-course accelerated hyperfractionation radiotherapy for nasopharyngeal carcinoma

目的 评价后程加速超分割放射治疗鼻咽癌的疗效及毒副反应。方法 86例鼻咽癌患者分为后程加速超分割治疗 (LCAF)组和常规分割治疗 (CF)组。其中LCAF组 43例 ,先用常规分割照射 3 6～ 40Gy 18～ 2 0次 2 4～2 8天 ,2Gy天 ,5次 1周 ,再用LACF照射 3 5～ 40 .5Gy 2 6～ 3 2次 17～ 2 1天 ,2次 1天 1.2 5～ 1.3 5Gy 天 ,间隔 6小时以上 ,总照射量 75～ 76.5Gy 46～ 5 0分次 45～ 48天 ;CF组 43例 ,总照射量 70Gy 3 5分次 47～ 49天。结果 1-,3 -,5 -年肿瘤局部控制率LCAF组分别为 95 .3 0 % ,90 .1% 86.0 % ;CF组分别为 90 .7% ,72 .1% ,65 .1% (P <0 .0 5 )。两组差异有显著性。 1-,3 -,5 -年生存率LCAF组分别为 97.7% ,72 .1% ,5 3 .5 % ;CF组为 95 .3 % ,69.8% ,48.8%。两组差异无显著性意义 (P >0 .0 5 )。两组的急性反应 ,LACF组口腔粘膜反应与CF组无显著性差异 (P >0 .0 5 )。结论 鼻咽癌LACF组的局部控制率明显高于CF组 ,但长期生存率无明显差异。

Objective To evaluate the clinical result and the major toxic effects of late-course accelerated hyperfrationation(LCAF)radiotherapy for nasopharyngeal carcinoma(NPC)patients.Methods 86 NPC patients were divided into LCAF radiotherapy and conventional fractionation(CF)group.Forty-there patients in CF group received conventional radiotherapy:2.0Gy/f,5 fractions a week to a total dose of 70Gy in 47～49 days.Forty-there patients in LCAF group were treated with the same fractionation as CF group until the dose of 36～40Gy,and the followed by LCAF radiotherapy:1.25～1.35Cy/f,twice daily with 6 hour interval between the two fractions,to the total dose of 75～76.5Gy in 45～48 days.Results The 1-,3-,5-year local control rates were 95.3%,90.1%,86.0%in the LCAF goup and 90.7%,72.1%,65.1% in the CF group,with the difference between the two groups significant(P<0.05).The 1-,3-,5-year survival rates were 97.7%,72.1%,53.5%;in the LCAF group and 95.3%,69.8,48.8% in CF group,without the difference between the two group(P>0.05),without finding any significant difference in majortoxic between there two groups.Conclusins The local control rate of NPC treated by LCAF radiotherapy is superior to CF. However there is no significant difference in the survival rates between the two groups.