20例晚期上颌窦癌同期加量放疗的临床研究

Concomitant boost radiotherapy for 20 cases of advanced maxillary sinus cancer

目的:分析晚期上颌窦癌同期加量照射与综合治疗的结果。方法:1995年以来本院行同期加量照射的20例晚期上颌窦癌病人,T3 4例,T4 16例,剂量DT 60～85Gy/5-6周,其中4例行挽救手术。结果:三年生存率37.7％,五年生存率22.7％,全组二年局控率37.4％,五年局控率20.8％。75％疗终残留,其中80％为后上壁残留。结论:晚期上颌窦癌行同期加量照射能提高放疗疗效,但仍不及术前照射加手术的综合治疗;单纯放疗应采用缩野追量,使剂量达DT85Gy左右。

Purpose: To analyze the results of advanced maxillary sinus cancer treated by concomitant boost radiotherapy and to discuss the optimal treatment methods. Methods: Since 1995, 20 cases of advanced maxillary sinus cancer were treated by late-course concomitant boost radiotherapy to a total dose of 60-85Gy/5-6weeks. Among the patients, 4 cases were T3, 16 cases T4. 4 cases received salvage surgery after radiotherapy. Results: The 3-, 5- year survival rates were 37. 7% , 22.7%, respectively, the 2-, 5-year local control rates were 37. 4% , 20.8%. respectively, 75% of the patients had residual disease after radiotherapy, and 80% of which were located at the posterior- superior wall of the sinus. (Conclusions: Concomitant boost radiotherapy to advanced maxillary sinus cancer is an effective, but the combination of radiotherapy and surgery is better. As for the radiotherapy scheme, a late-course concomitant boost with cone-down technique to a total dose of approximately 85 Gy is preferred.