鼻咽癌放疗疗程延长对疗效影响的研究

STUDY ON THE INFLUENCE TO THE THERAPEUTIC EFFECTS WITH PROLONGED PERIOD OF RADIOTHERAPY IN NASOPHARYNGEAL CARCINOMA

目的 :探讨放疗疗程延长对鼻咽癌疗效的影响。方法 :1990年— 1995年间 ,因休假致疗程中断的鼻咽癌 176例与同期连续放疗的 182例进行对比 ,均接受常规分割放疗。有中断的 176例中 ,2 6例曾补量照射。疗程延长时间为 5天～ 15天不等。结果 :疗程延长的 176例中 ,局部失败 4 7例 ,3年生存率为 6 0 .9% ,5年生存率为 4 1.6 % ;连续的 182例中 ,局部失败 4 2例 ,3年生存率为 75 .6 % ,5年生存率为 5 4 .7%。在 <36 Gy前中断的 84例 ,局部失败 17例 ,3年生存率为 6 8.5 % ,5年生存率为 4 9.6 % ;≥ 36 Gy后中断的 92例 ,局部失败 30例 ,3年生存率为 5 4 .3% ,5年生存率为 33.6 %。补量的 2 6例 ,局部失败 6例 ,3年生存率为 72 .8% ,5年生存率为 4 9.3%。结论 :鼻咽癌因节假日休息等因素使总疗程延长时 ,其局控率和 3年、5年生存率均会下降。在剂最≥ 36 Gy后中断放疗 ,疗效影响更明显。补量组疗效明显优于不补量组。

Objective:To investigate the influence to the therapeutic effect with prolonged the period of radiotherapy in patients with nasopharyngeal carcinoma.Methods:Between 1990 and 1995,176 patients who intermitted their treatment for holiday and 182 patients who received successive radiotherapy were admitted into the study.The patients′ period of treatment were prolonged about 5-days.All patients received routine divided radiotherapy.26 of 176 patients with prolonged period of treatment received supplementary radiotherapy.Results:There were significant differences in local failure,3-year survival rate and 5-year survival rate between patients with prolonged period of radiotherapy and those without delay (47 versus 42,60.9 % versus 76.5 %,41.6 % versus 54.7 %,respectively,P<0.05).There were also significant differences in local failure,3-year survival rate and 5-year survival rate between patients intermitted treatment at radiotherapy dose<36 Gy and those at radiotherapy dose ≥36 Gy (17 versus 30,68.5 % versus 54.3 %,49.6 % versus 33.6 %,respectively,P<0.05).26 patients received suplementary radiotherapy with different doses,local failure,3-year survival rate and 5-year survival rate were 6,72.8 % and 49.3 %.Conclusion:When the total period of treatment in patient with nasopharyngeal carcinoma was prolonged by some reasons such as holidays,local control rate,3-year survival rate and 5-year survival rate will decrease.In those intermitted treatment at radiotherapy dose≥36 Gy,the influence to therapeutic effects would be more distinct.If patients received supplementary radiotherapy after intermitted treatment,their therapeutic effects was distinctly superior to those without that.