逐步递量加速超分割放射治疗复发性鼻咽癌

目的观察逐步递量加速超分割放射治疗复发性鼻咽癌的近期疗效及毒副反应。方法46例复发性鼻咽癌随机分为常规分割放疗组（对照组）及逐步递量加速超分割放疗组（研究组），每组各23例。对照组：常规照射，2Gy／次，1次／d，5次／周，鼻咽部复发灶总剂量DT60—66Gy／6．0～6．6周；研究组：第1、2、3、4、5周剂量分别为1．1、1．2、1．3、1．4、1．5Gy／次，每天2次，两次间隔时间〉6h，每周5次，鼻咽部复发灶总剂量DT65Gy／5周。结果放疗结束后3个月，研究组和对照组鼻咽复发灶完全缓解（CR）、部分缓解（PR）率分别为82．6％、17．4％和52．2％、47．8％（P〈0．05），两组比较差异有统计学意义。研究组口咽急性放射性反应高于对照组（P〈0．05），但是可以耐受。结论逐步递量加速超分割放疗能提高复发性鼻咽癌的近期疗效，急性放射性反应患者可以耐受，远期疗效和后期放射损伤有待进一步随诊观察。

Escalated hyperfractionated accelerated radiation therapy for recurrent nasopharyngeal carcinoma

Objective To observe the immediate responses and side effects in escalated hyper- fractionated accelerated radiation therapy for recurrent nasopharyngeal carcinoma （NPC）. Methods A total of 46 patients with recurrent nasopharyngeal carcinoma were randomized into two groups, the conventional fractionation group （control group ） and the escalated hyperfractionated accelerated radiation therapy group（ study group）. Twenty -three patients were asigned to each group. The control group patients were treated by 2 Gy daily,5 days per week, the total dose of nasopharyngeal carcinoma was 60 - 66 Gy. The study group patients were treated by escalated dose ： 1.1,1.2,1.3, 1.4,1.5 Gy,twice fractions daily （over 6 hours interval） were given from the 1st to 5th weeks respectively, The total dose of nasopharyngeal carcinoma was 65 Gy. Results Three months after finishing the radiotherapy, the CR and PR rates of recurrent lesions were 82.6%, 17.4% in the study group and 52.2%, 47.8% in the control group（ P 〈 0.05）. There was significant difference between the two groups. The acute radiation reaction of pharynx was higher in the study group than that in the control group, There was significant difference between the two groups （ P 〈 0.05 ）. Conclusions The results of this study showed that escalated hyperfractionated accelerated radiation therapy can promote immediate response for recurrent nasopha- ryngeal carcinoma. The survival rate and late complications in long term are worth while of further study.