鼻咽癌原发灶复发再程放疗疗效分析

Analysis of Re-irradiation Results in Recurrent Nasopharyngeal Carcinoma

目的 :了解鼻咽癌原发灶复发再程放疗的治疗价值 ,分析鼻咽癌原发灶复发再程放疗的疗效和影响疗效的因素。方法 :1998年 4月 - 2 0 0 0年 4月 ,收治的 5 4例鼻咽癌放疗后原发灶复发患者 ,所有患者接受外照射放疗 ,放疗剂量为 4 0～ 80Gy ,2 0～ 4 0次 / 4～ 8个周。结果 :总的 3年生存率、局部控制率、远处转移率分别为 5 0 0 %、5 3 7%和 18 5 %。复发间隔时间 2 4个月以上者 ,3年生存率高 ;再程放疗剂量不低于 6 6Gy和T2 期的病例 ,3年生存率和局部控制率高。结论 :鼻咽癌放疗后原发灶复发再放疗仍是有效的治疗手段 ,尤其是对于复发间隔时间 2 4个月以上的早中期病例 ,在治疗上可采用一些非常规治疗方法 ,再程放疗总剂量不应低于 6 6Gy。

Objective To evaluate the value of re irradiation in recurrent nasopharyngeal carcinoma (NPC) and analyze the re treatment results and the influencing factors.Methods Fifty four cases of recurrent NPC received radiation therapy during April 1998 to April 2000 in hospital.All patients received external beam irradiation.The re irradiation dose was 40～80 Gy for 20～40 f/4～8 w.Results The overall 3 year survival rate,local control rate and distant metastasis rate were 50 0%,53 7% and 18 5%. The cases of interval of recurrence longer than 24 months had a better 3 year survival rate.The re irradiation dose over 66 Gy and stage T 2 patients had a better survival rate and local control rate.Conclusions The re irradiation is efficacy for the recurrent NPC,especially for the patients in early or mid stage whose intervals of recurrence were longer than 24 months,and the re irradiation dose should be over 66 Gy.