鼻咽癌调强放疗 35 例临床分析

目的：评价调强放射治疗（IMRT）对早期鼻咽癌的近期疗效并观察放射不良反应.方法：分析 35例全程IMRT治疗的初治鼻咽癌患者（Ⅰ期14例,Ⅱ期21例 ）.鼻咽部和锁骨上及上颈部淋巴引流区采用IMRT技术照射治疗.结果：3年的总体生存率、无局部复发生存率、无进展生存率和无远处转移生存率分别为88.3%、91.4%、74.3%、94.3%.最严重的急性反应是放射性黏膜炎,2-3级分别为22.9%和45.7%.晚期不良反应主要表现为口干.结论：IMRT是鼻咽癌的有效治疗手段.对初治者早期鼻咽癌可以获得理想的剂量分布,局部区域控制率较高,不良反应低.能降低靶区正常组织的照射剂量和急性反应,提高肿瘤病人的生存质量.

Clinical analysis on 35 cases of nasopharyngeal carcinoma treated by intensity modulation radiated therapy

Objective：To evaluate the short - term therapeutic efficacy of intensity modtdation radiated therapy （IMRT） on nasophatTngeal carcinoma at early stage and observe the adverse reactions. Methods：All 35 patients with nasopharyngeal carcinoma treated by initial treatments with whole - range IMRT were analyzed （ among which 14 pa- tients were stage Ⅰ,21 patients were stage Ⅱ）. IMRT was carried out for lymphatic drainage areas in nasopharynx,su- praclavicular and superior cervix. Results：The overall 3 -year survival rate, locally relapse -free survival rate, pro- gress free smwival rate and the distant lnetastasis free smwival rate were 88.3% ,91.4% ,74.3% and 94.3% respec- tively. The lnost severe acute reaction was radioactive lnucocitis. The patients of grades 2 - 3 accounted for 22.9% and 45.7% respectively. The adverse reactions at advanced stage was lnainly dry mouth. Conclusion：IMRT is an ef- fective therapeutic method for nasopharyngeal carcinolna, ideal dosage distribution can be obtained for nasopharyngeal carcinoma at early stage for patients of initial treatments. The locoregional control rate was relatively high. The adverse reactions were low. Radiation dose and acute reactions in norlnal tissues within the target areas can be reduced, and the life quality of patients can be improved.