鼻咽癌局部复发适形成疗近期疗效分析

目的：采用适形放疗提高鼻咽癌局部复发的治疗效果，探讨最佳剂量分割方法。方法：1997年9月至2000年2月对41例鼻咽癌局部复发病人行适形放疗。27例常规外照射39Gy，在3周内分30次完成后进行低分割适形放疗，80%等剂量线4～75Gy/次，总量20～24Gy，分4次在2周内完成；14例全程超分割适形放疗，90%等剂量线59.8Gy，4.6周内分46分完成。结果：适形放疗的等剂量线分布在三维方向上与靶区适形。急性放射性粘膜炎、后组颅神经损伤、张口困难两组相似，低分割组22%鼻咽粘膜坏死，3.7%视神经损伤。超分割组无鼻咽粘膜坏死、视神经损伤。两组治疗有效率均达93%。结论：鼻咽癌局部复发病人采用超分割适形放疗取得满意的近期效果，低分割适形放疗不宜采用。

Short-Term Effect of Conformal Radi otherapy for Recurrent Nasopharyngeal Carcinoma

Objective:The current study was designed to eva luate the treatment results of nasop haryngeal carcinoma by conformal radiotherapy.Methods :From September 1997to February 2000,a total of 41cases of recurrent nasopharyngeal carcinoma were trea ted by conformal radiotherapy.Amon g them,27cases were treated by late-course hypofraction conformal radiothera py with the dose of 20-24Gy at 80%isod ose,4-7Gy per time,following routine radiotherapy of 39Gy /30f /3weeks.F ourteen cases received total-cours e conformal radiotherapy with the dose of 59.8Gy /46f /4.6weeks at 90%isodose.Results:The reference isodose curves conform to the target in three dimensions in conformal radiotherapy.The acut e radiation mucositis ,cranial nerv e paralysis and trismus incidence we re similar in two groups ,however ,in the hypofr actionation group 22%developed nec rosis of nasopharyngeal mucosa,3.7%developed reduced optic nerve lesio n,whereas none of the hyperfraction ation group had these complications.The tumor response rate were both 93%for two groups.Conclusion:Hyperfraction conformal radiotherapy is effective in the treatment of recurrent nasopharyngeal carcin oma and has relatively lower inciden ce of radiation complication.