283例鼻咽癌超分割放疗的近远期临床疗效分析

目的 探讨超分割放疗治疗鼻咽癌的疗效和并发症情况.方法 对283例鼻咽癌患者采用超分割放疗治疗,部分病例加用5-氟尿嘧啶加顺铂或卡铂方案化疗,放疗采用60Co-γ线外照射,每次1.2 Gy,每天2次,每周5 d,间隔≥6 h,全疗程鼻咽中位放疗剂量72 Gy,颈部中位放疗剂量68.4 Gy.结果 放疗过程中黏膜反应≥3级的病例占12.4%,放化疗结束时完全缓解率为93.6%,1年生存率为93.6%,2年生存率82.7%,5年生存率为60.1%.结论 超分割放疗患者能耐受,疗效好,为鼻咽癌患者提供了一种可能有效的治疗选择,其确切疗效有待大规模临床试验验证.

Short and long term clinical outcome of 283 cases of nasopharyngeal carcinoma patients treated with hy-perfractionated radiotherapy

Objective To approach the therapeutic effects and complication of hyperfractionated radio-therapy for nasopharyngeal carcinoma. Methods From January 2000 to November 2002,283 patients with na-sopharyngeal carcinoma were treated with hyperfraetionated radiotherapy. For hyperfractionated radiotherapy,γ-ray from 60Co was performed and two fractions of 1.2 Gy were given daily,with an interval of≥6 h,5 days per week to a median dose of 72 Gy for nasopharynx and 68.4 Gy for neck. For some patients, carboplatin or cispla-tin and 5-fluorouracil were transfused. Results The incidence rate of≥3 grade acute mueositis was 12. 4%.The complete remission rate after treatment was 93.6%. The 1,2 and 5 year survival rate was 93.6% ,82. 7%and 60. 1% respectively. Conclusion patients treated with hyperfractionated radiotherapy have good tolerance and therapeutic effect. It provids a treatment means for nasopharyngeal carcinoma. But it must be validated by the large-scale clinical trials.