颅底野补量对T3、T4期鼻咽癌复发的影响

目的分析颅底野补量对T3、T4期鼻咽癌患者颅底复发的影响。方法对从2004年1月~2005年4月收治的303例经病理确诊为鼻咽癌,分期T3、T4的初治患者做随机分组研究,对照组鼻咽常规放疗剂量为(70.05±1.05)Gy。研究组在常规放疗后接受颅底补量4～8Gy(补量组),对照组未进行颅底补量。结果补量组2、3、5年颅底局控率分别为98%、91.8%、86.8%,对照组分别为93.4%、76.4%、65.1%,两组之间的差异具有统计学意义(P﹤0.05)。中位复发时间补量组为46个月,对照组为38个月,差异有统计学意义(P=0.02)。补量组与对照组的放射性脑损伤发生率分别为12.08%和7.79%,两组间的差异无统计学意义(P﹥0.05)。结论颅底补量放疗可减少T3、T4分期鼻咽癌患者的颅底复发率,放射性脑病发生率未增加。

Impact of dose boost in skull base on the recurrence in stage T3,T4 of nasopharyngeal neoplasms

OBJECTIVE To study recrudescence the impact of dose boost in skull base on the recurrence in stage T3,T4 of Nasopharyngeal neoplasms.METHODS From January 2004 to April 2005,303 cases admitted to stage T3,T4 of nasopharyngeal carcinoma by the pathology diagnosis was initially accepted the nasopharyngeal convention radiotherapy dosage for(70.05±1.05)Gy.But 149 of them after conventional radiotherapy accepted dose boost 4-8 Gy(dose boost group),154 cases were not been carried on dose boost(control group).RESULTS The 2-,3-,5-year skull base control rates in the dose boost group were respectively 98%,91.8%,86.8%,respectively 93.4%,76.4%,65.1% in the control group,the differences between two groups were significant(P﹤0.05).The incidences of radioactive brain damage of the dose boost group and the control group were respectively 12.08% and 7.79%,difference between two groups had no significances(P﹥0.05).CONCLUSION Dose boost in skull base can reduce stage T3,T4 of nasopharyngeal carcinoma patient’s recurrence rate of skull base,but the incidence of radioactive brain illness is not increased.