适形放射治疗鼻咽癌局部复发的探讨

目的探索鼻咽癌放疗后局部复发患者用适形放疗再治疗的即期疗效和并发症,最佳剂量和分割方法。方法对15例鼻咽癌放疗后局部复发患者进行适形放疗。计划照射剂量为51～71Gy,先以2Gy/次,5次/周,累积剂量达20～30Gy后,再行加速超分割照射,1.5Gy次,2次/天,10次/周(部分病例全程加速超分割照射照射剂量为51Gy)。结果15例中取得病理的8例,均为鼻低分化鳞癌,由于复发部位解剖结构关系难于取得病理而经MR及CT影像学证实局部复发的7例。初次放疗至再放疗的中位间隔时间为44个月(12～146个月),再放疗肿瘤中位剂量为63Gy(51～71Gy)。结论鼻咽癌放疗后局部复发,应用适形放疗对大多数患者均能耐受,对控制复发灶有较好的即期疗效。对远期放射后毒副反应和疗效有待积累资料再作进一步评价。

The study of conformation radiotherapy treatment for the local recurrence of nasopharyngeal carcinoma

Objective To study the curative effect,compli cation,optimal dose and separation methods of conformation radiotherapy to treat the local recu rrence of nasopharyngeal carcinoma after routine radiotherapy.Methods Fifteen cases with local recurrence of nasopharyngeal carcinoma after routine radiothera py adopted conformation radiothera py treatment.Results Among 15cases 8cases were proven by p athology ,all of them were low -diffe rentiated squamous carcinoma;the o thers(7cases)were proven by MR and CT examinations.The average interval time from firs t radiothrapy to second radiotherap y was 44months.The average dosage for second radiotherapy was 63Gy.Conclusion For most cases with local recurrence of nasopharyngeal carcinoma after routine radiotherapy,to perform conformation radiotherapy trea tment are endurable and it is quite effective for controling re-current focus.The distant side -eff ect and curative effect are remained further evaluation.