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局部残留或复发鼻咽癌的分次立体定向放射治疗 被引量:6

Fractionated stereotactic radiotherapy for locally residual or recurrent nasopharyngeal carcinoma
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摘要 目的 评价分次立体定向放射治疗 (FSRT)对局部残留和复发鼻咽癌的初步疗效。方法 应用FSRT对 30例局部残留 (11例 )或复发 (19例 )鼻咽癌患者分 2个组进行治疗 ,其残留组和复发组中位处方剂量分别为 18Gy和 4 8Gy ,中位分次量分别为 6Gy和 8Gy ,每周 2次。结果 可评价例数共 2 9例 ,FSRT治疗后 3个月残留组的CR和PR各为 6 /11和 3/11,复发组各为 8/18和 8/18。全组病例随诊 3.4~ 37.9个月 (中位值 15个月 ) ,残留组 1和 2年总生存率、无瘤生存率、无局部复发生存率和无远地转移生存率分别为 77.8%和 6 6 .7%、5 6 .8%和 5 6 .8%、88.9%和 88.9%、75 .0 %和75 .0 % ,复发组相应为 6 9.8%和 5 9.8%、5 3.4 %和 4 4 .5 %、76 .6 %和 6 3.8%、70 .5 %和 5 8.7%。残留组和复发组生存患者卡氏评分≥ 90者分别占 8/8和 11/13。结论 FSRT对局部残留或复发鼻咽癌有较好的局部控制效果和较高的安全性 ,区域和远地转移是治疗失败的主要原因。 ObjectiveTo evaluate the preliminary results of locally residual or recurrent nasopharyngeal carcinoma treated with fractionated stereotactic radiotherapy (FSRT). MethodsFrom September 1999 to July 2002,30 patients with locally residual(n=11) or recurrent (n=19) nasopharyngeal carcinoma were treated by FSRT in our department. The patients were irradiated twice weekly,with a median prescription dose at 80%-90% isodose line to 18 Gy (10-24 Gy) by 6 Gy (5-8 Gy) per fraction for the residual arm and to 48 Gy (18-49 Gy) by 8 Gy (6-8 Gy) per fraction for the recurrent arm. ResultsTwenty-nine patients were evaluable for analysis,with a median follow-up time of 15 months (3.4 ~ 37.9 months) for the surviving patients. The CR and PR rates at 3 months after FSRT were 6/11 and 3/11 for the residual arm,8/18 and 8/18 for the recurrent arm. The overall 1- and 2-year survival,disease-free survival,local relapse-free survival and distant metastasis-free survival rates were 77.8% and 66.7%,56.8% and 56.8%,88.9% and 88.9%,75.0% and 75.0% for the residual arm, 69.8% and 59.8%,53.4% and 44.5%,76.6% and 63.8%,70.5% and 58.7% for the recurrent arm. Incidence of KPS≥90 in the Surviving patients were 8/8 and 11/13 for the residual and recurrent arms. ConclusionsFractionated stereotactic radiotherapy is effective and safe for local control of locally residual or recurrent nasopharyngeal carcinoma. Regional and distant metastasis are the main cause of failure.
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2004年第1期4-7,共4页 Chinese Journal of Radiation Oncology
关键词 局部残留 复发 鼻咽癌 分次立体定向放射治疗 放射损伤 Nasopharyngeal neoplasms Neoplasm residual,local Neoplasm recurrent,local Stereotactic radiotherapy
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