无法切除的复发头颈部鳞癌的姑息放疗

为评价头颈部鳞癌术后复发患者行姑息放疗的疗效及其影响因素，对１９８８年７月至１９９６年２月在我科接受姑息放疗的１０６例患者的资料行回顾性分析。结果：放疗后ＣＲ２２．６％（２４／１０６），ＰＲ３８．７％（４１／１０６），ＮＲ３８．７％（４１／１０６）；总有效率为６１．３％（６５／１０６）；放疗后挽救性手术成功率为４／９；疗后６３．２％（６７／１０６）的患者Ｋａｒｎｏｆｓｋｙ得分上升，症状减轻，生存质量提高；１、２、３年生存率分别为５４．７％（５８／１０６）、２１．７％（２３／１０６）和５．７％（６／１０６）；远处转移率２９．２％（３１／１０６），放疗并发症１０．４％（１１／１０６）。结论：姑息放疗是晚期头颈部鳞癌术后复发患者一种较好的治疗选择；为了提高疗效，放射剂量应尽可能高于５０Ｇｙ，采用超分割连续放疗技术和避免分段。

Palliative Radiotherapy for Recurrence of Postoperative Squamous Cell Carcinoma of Head and Neck Region

One hundred and six patients with advanced recurrence of postoperative squamous cell carcinoma of head and neck underwent palliative radiotherapy in our hospital during the period of July 1988 to February 1996.The material of the patients were studied retrospectively to analyse the results of palliative radiotherapy. It was shown that the overall rates of CR,PR,NR were 22.6% (24/106),38.7% (41/106) and 38.7% (41/106) respectively.The successful rate of postradiation rescue surgery was noted in 4 out 9 cases. The Karnofsky score of performance status in 67 patients (63.2%) was evaluated. The symptoms and life quality were improved in most of the patients after treatment. The 1 , 2 3 year survival rates were 54.7%,32.7% and 5.7% respectively. The frequency of distant metastases and radiation complications was defined as 29.2% and 10.4%. Palliative radiotherapy is a better treatment choice for patients with advanced recurrence of postoperative squamous cell carcinoma of head and neck region. For the sake of gaining best effect,large rediation dose (more than 50Gy) and hyperfraction continuous radiotherapy should be given, and split course irradiation should be avoided.