鼻咽癌后程X刀分次推量放疗的疗效观察

 目的 探讨鼻咽癌的放射治疗疗效。方法 将1996年至2000年常规放疗及后程X刀分次推量放疗的患者，按入组条件分为二组，分组进行肿瘤区有效生物剂量估计，低剂量区剂量估计，正常组织（口腔黏膜、唾液腺）剂量估计，近期疗效评价及1，3，5年生存率。结果 两组肿瘤区放射治疗有效生物剂量估计分别为83.23 Gy，99.09 Gy；两组咽旁间隙、茎突、颈动、静脉区低剂量区放射剂量估计分别为54.96 Gy，76.8 Gy；正常组织（口腔黏膜、唾液腺）剂量估计为66.24 Gy，53.76 Gy；两组完全缓解（CR）率、部分缓解（PR）率分别88.4 %，100 %及96.4 %，100 %；两组1，3，5年生存率分别为92.8 %，71.4 %，53.5 %；96.2 %，84.6 %，76.6 %。结论 后程X刀分次推量放疗提高了鼻咽癌常规放疗肿瘤区及低剂量区的放疗剂量，降低了正常组织的损伤剂量，是提高近期疗效及1，3，5年生存率的主要因素。临床放疗应严格筛选适应证，选择侵犯咽旁间隙、茎突、颈动、静脉区的病例为主。

Evaluation of late course fractionated stereotactic radiotherapy for nasopharyngeal carcinoma

Objective To evaluate the results of radiotherapy(RT) of nasopharyngeal carcinoma(NPC). Methods From 1996 to 2000, the results of 54 NPC patients treated by conventional RT and late course dose region and normal tissues(nonnasality mucous and spit gland) was evaluated. Short term outcomes and 1- , 3- and 5-year survival rate was observed. Results Mean dose of target in two groups(RT and RT+ FSRT ) was 83.23 Gy and 99.09 Gy respectively. Mean dose in low dose region was 54.96 Gy and 76.8 Gy. In normal tissue, mean dose was 66.24 Gy and 53.76 Gy. CR and PR in two groups was 88.4 %, 100 % and 96.4 %, 100 %. The 1-, 3- and 5-year survival rate was 92.8 %, 71.4 %, 53.5 % and 96.2 %, 84.6 %, 76.6 %. Conclusions Late course FSRT can boost the dose in target and low dose region of conventional RT. At the same time normal tissue damage is reduced. These are the cause of the improvement of the 1-, 3- and 5-year survival rate. In clinical practice cases must be choosed correctly. NPC patients with tumors overpassing to pharyngeal space, styloid process and carotid artery and jugular vein region should be the optimal cases to be treated by FSRT after conventional RT.