调强放射治疗技术治疗复发鼻咽癌22例疗效分析

目的：分析调强放射治疗（IMRT）技术在复发鼻咽癌治疗中的近期疗效。方法回顾性分析22例复发鼻咽癌同步推量IMRT患者的临床资料，分析治疗疗效及急性毒副作用。结果全部患者住院治疗时间平均50 d，中位随访时间12个月。22例患者治疗结束时无死亡病例，随访期间死亡3例（均为转移患者），总生存率86．3％（19／22），局部再复发2例，2例骨转移，1例喉及颈部淋巴结转移。局部控制率63．6％（14／22）。急性毒副反应主要有急性皮肤、口咽黏膜损伤（12例）及骨髓抑制（4例）。1例出现听力下降听神经受损症状，1例出现下颌骨坏死，所有患者口干症状较首程放疗均有加重。结论 IMRT技术治疗鼻咽癌患者总生存率有明显提高，但复发肿瘤的远处转移、再次放疗导致的不良反应仍需在临床实践中进一步发展完善，IMRT治疗复发鼻咽癌应用前景广阔。

Efficacy analysis of IMRT on 22 cases with recurrent nasopharyngeal carcinoma

Objective To analyze the efficacy of IMRT in the treatment of recurrentnasopharyngeal carcinoma. Methods Clinical data of 22 patients with recurrent nasopharyngeal carcinoma （NPC）were retrospectively analyzed,We have recurrent NPC tune the amount of synchronization push radiation therapy in patients with clinical data,treatment efficacy and acute toxicity were analyzed.Results All patients were hospitalized on average 50 days, between median follow-up period of 12 months.At the end of 22 patients with no treatment deaths,three deaths （both metastasis） during follow-up,overall survival 86.3%（19/22）,local recurrence in 2 cases,2 cases of bone metasta-sis,1 case of throat and neck lymph node metastasis.The local control rate was 63.6%（14/22）.Acute toxicity main-ly acute skin,oropharyngeal mucosa （12 cases） and bone marrow suppression （4 cases）.1 patient had symptoms of hearing loss and auditory nerve damage,1 case of necrosis of the mandible,all symptoms of dry mouth in patients with radiotherapy were heavier than that of the first drive.Conclusion With the growing popularity of IMRT,NPC patients had significantly improved overall survival, but distant metastasis and recurrence of the tumor, radiotherapy again cause adverse reactions in clinical practice still needs further development and improvement,IMRT treatoffing with re-current nasopharyngeal has broad prospects.