后程加速超分割放射治疗I～Ⅱ鼻咽癌的疗效观察

目的:观察后程加速超分割放射治疗早期鼻咽癌的临床疗效、毒副反应及后遗症。方法:将108例I～II期鼻咽癌患者随机分为常规分割放疗组常规组和后程加速超分割放疗组后超组,每组54例。常规组照射2Gy/次,5次/周总量为70Gy/7周。后超组前3.5周照射同常规组,然后开始1.5Gy/次,2次/日,间隔6h,总量为69Gy/6周。结果:鼻咽部肿瘤消退率:常规组为70.97%22/31,后超组为89.47%(34/38),但两组差别无显著性意义(P=0.05);颈部淋巴结完全消退率:常规组为86.67%26/30,后超组为90.91%30/33,两组差别无显著性意义(P>0.05);两组1、2、3年生存率分别为96.12%、80.97%、78.55%和98.13%、93.95%、90.87%P=0.06,无明显的统计学差异;两组放疗毒副反应及后遗症也无显著性差别(P>0.05)。结论:I～II期鼻咽癌后程加速超分割放疗疗效未见优于常规分割放疗,但未加重放疗毒副反应及增加放疗后遗症,有必要扩大病例并作长期随访研究。

Treatment of Stage I -II Nasopharyngeal Carcinoma with Late Course Accelerated Hyperfractionation Radiotherapy

Objective:The current study was designed to observe the clinical results of late cou rse accelerated hyperfractionation(LCAH)radiotherapy in Stage I -II nasopharyngeal carcinoma (NPC)patients.Methods:A total of 108patients with Stage I -II NPC were div ided at random into two groups:conventional fractionation(CF)and LCAH,The patients in CF group received a fraction of 2Gy daily,5days per week,to to tal dose of 70Gy /7weeks.The patient s in LCAH group were treated with the same fractionation as CF group to dose of 36-40Gy,and followed by late course accelerated hyperfractionation ra diotherapy:1.5Gy,twice daily,with the interval of 6hours between frac tions,to total dose of 69Gy /6weeks.Results:The complete response rate in the nasopharynx was 89.47%in the LCAHR and 70.97%in the CFR at the end of the course(P=0.05).Disappeared rate of cervical lesio n was not significant different betw een two groups(P>0.05).The survival rates of 1,2,and 3-year were 98.13%,93.95%,90.87%in the L CAH and 96.12%,80.97%,78.55%in the CF,respectively(P=0.06).There was no significant difference in radiation reaction and sequela between two groups(P>0.05).Conclusion:The clinical results of LCAH radiothera py in Stage I -II NPC may be better than conventional fractio nation radiotherapy,is worth further study.