鼻咽癌不同方式放疗疗效分析

目的 分析比较鼻咽癌不同放疗方式的疗效。方法 回顾性分析1997年1月～2002年1月220例鼻咽癌初治患者临床资料。分别采用常规外照射放疗、体外照射联合腔内放疗、三维适形放疗治疗。常规外照射放疗患者72例，接受70～78Gy的根治放疗；体外照射联合腔内放疗92例，外照射60～65Gy（咽旁间隙浸润者予以65～70Gy），腔内放疗总剂量为8～22Gy，分1～3次，于1～3周完成；三维适形放疗56例，外照射40Gy后加三维适形放疗，剂量30～40Cy。统计分析各组3年生存率、3年局部控制率及并发症发生率，并比较其差异。结果 常规放疗组3年生存率、3年局部控制率为81．9％、77．8％；体外照射联合腔内放疗组及三维适形放疗组分别为80．9％、84、0％及78．6％、80．4％，组间比较差异无统计学意义（P〉0．05）；体外照射联合腔内放疗组及三维适形放疗组的各种并发症发生率明显低于常规放疗组（P〈0．05），而前两组间无明显差异（P〉0．05）。结论 三种方式放疗治疗鼻咽癌疗效无明显差异，但腔内放疗、三维适形放疗相对外照射剂量降低，减轻了正常组织器官的放射损伤，从而减少了放疗并发症的发生。

Comparison of Therapeutic Effects of Nasopharyngeal Carcinoma Treated by Different Types of Radiotherapy

Objective To compare the therapeutic effects of nasopharyngeal carcinoma treated by different types of radiotherapy.Methods Clinical data of 220 cases of nasopharyngeal carcinoma diagnosed according to the 1992 Fuzhou Meeting Regulation from January1997 to January 2002 were analyzed retrospectively.The patients were treated with conventional radiotherapy(CRT),external beam radiation combined with intracavitary brachytherapy(EBRIB),or external beam radiation combined with 3dimensional conformal radiation therapy(3DCRT) respectively.Of all the cases,72 were treated with CRT,94 with EBRIB and 56 with 3DCRT.The 3-year complete control rates,3-year overall survival rates and complication rates in dirrerent groups were calculated and compared with each other.Results The 3-year complete control rates,and 3-year overall survival rates of CRT group, were 81.9%,77.8%,while those of EBRIB group were 80.9%,84.0%,and 78.6%,80.4% for 3DCRT group respectively.Their differences were statistically insignificant(P>0.05).However,the complication rates of EBRIB group and 3DCRT group were obviously lower than those of CRT group(P<0.05).Conclusion The therapeutic effects of nasopharyngeal carcinoma treated by different types of radiotherapy are almost equal.The complication rates were obviously lowered down by EBRIB and EBRLRLS due to the decrease of the dosage of outside radiation and reduction of normal tissues damage.