鼻咽癌低氧放疗的前瞻性研究

探讨鼻咽癌低氧放疗的临床应用价值。方法 :1993年 7月～ 1995年 10收治的 12 0例鼻咽癌患者 ,根据临床期别区组设计 ,随机分为低氧放疗组和常规放疗组 ,均给予钴 - 6 0外照射 ,面颈联合野照射 34Gy后改面颈分野照射至鼻咽中平面剂量 70Gy ,低氧放疗组病例在放疗同时吸入 10 .5 %的低氧。结果 :两组近期疗效、长期生成率无明显差异 (P >0 .0 5 ) ,而低氧放疗组严重口干反应、严重口腔粘膜反应明显低于常规放疗组 (P <0 .0 0 1) ;张口困难、放射性脑病的发生率低于常规放疗组 ,但无统计学意义 (P >0 .0 5 )。结论 :低氧放疗可减轻鼻咽癌患者放射治疗的副作用 ,降低并发症的发生率。低氧放疗能否降低鼻咽癌患者放射性脑病及严重张口困难等后遗症的发生率 ,尚难以推断。

PROSPECTIVE STUDY ON HYPOXIC RADIOTHERAPY OF NASOPHARYNGEAL CARCINOMA

Objective:To determine the clinic applied value of hypoxic radiotherapy of nasopharyngeal carcinoma.Method:A total of 120 patients with nasopharyngeal carcinoma treated in our hospital from July 1993 to October 1995 were divided randomly into hypoxic radiotherapy group and conventional group by clinic stage.Both the two groups of patients were irradiated by face-neck independent field until the central plane of the nasopharynx received the total dose of 70 Gy after the dose of 34 Gy was given by facial-upper neck field treated with Co-60 outer-irradiation.In the hypoxic radiotherapy group,patients inhaled 10.5% oxgen before radiotheray.Result:The difference between the two groups in the short-period curative effect and long-term survival rate did not appear markedly but the serious reactions of oral mucosa in the hypoxic radiotherapy group were much lower than those in the conventional group ( P <0.001).The rate of the difficulty in opening mouth and irradiation induced-encephalopathy in the hypoxic radiotherapy group was also lower than that in the conventional group,which had no statistical significance.Conclusion:Hypoxic radiotherapy can alleviate the side-effect of the radiotherapy and reduce the rate of complication in the nasopharyngeal carcinoma patients.Whether hypoxic radiotherapy can reduce the rate of the sequela such as the difficulty in opening mouth and radiation induced-encephalopathy is difficult to deduce.