鼻咽癌低氧放疗的临床观察

背景与目的:近年来国内肿瘤低氧放疗的临床应用开展很快。低氧对正常组织放射保护作用已被证实,但它是否对肿瘤也存在保护作用尚无肯定答案。本研究比较鼻咽癌患者常规放疗和低氧放疗的临床结果,并加以分析。方法:收集1992年3月至2000年6月间在我院接受低氧放疗或常规放疗的117例鼻咽癌病例。其中Ⅰ期11例、Ⅱ期30例、Ⅲ期57例、Ⅳ期19例。低氧组69例接受低氧放疗,常规组48例接受常规放疗。两组患者年龄、性别、TNM分期、病理分类、辅助治疗等均无显著性差异(P>0.05)。全部病例均应用6MVX线和8～12MeV电子线照射,鼻咽部剂量72Gy(68～82Gy),颈部转移淋巴结剂量64Gy(60～70Gy)。结果:2～3级急性口咽粘膜、唾液腺损伤和2～3级晚期口干症在低氧组的发生率分别为23.2%、26.1%和37.7%,在常规组分别为77.1%、62.5%和91.7%(P≤0.01)。肿瘤局部复发、颈淋巴结复发转移和远处转移率在低氧组分别为14.5%、23.2%和21.7%,常规组分别为12.5%、20.8%和18.8%(P>0.05)。低氧组1、3、5、7年生存率分别为97.1%、83.7%、74.4%和54.5%,常规组分别为97.9%、86.8%、70.2%、54.7%(P>0.05)。结论:低氧能减轻放射治疗引起的不良反应,降低并发症发生率;初步观察低氧放疗后肿瘤复发、转移及患者生存情况与常规放疗无明显差异,但仍需

Clinical observation of hypoxic radiotherapy for nasopharyngeal carcinoma

BACKGROUND & OBJECTIVE: The clinical application of hypoxic radiotherapy (RT) was developed at a high speed in China in recent years. The protective effect of hypoxic RT on normal tissues has been proved. However, there was not an affirmative answer whether hypoxic RT had any protective effect on tumor. This study was designed to analyze this question by comparing clinical results of hypoxic RT with regular RT in nasopharyngeal carcinoma (NPC) patients. METHODS: A series of 117 patients with NPC who underwent hypoxic RT or regular RT between March 1992 and June 2000 in PLA 309 Hospital was enrolled. The cancers were staged as I, II, III, and IV in 11, 30, 57, and 19 cases, respectively. Of these, 69 received hypoxic RT, and 48 received regular RT. There was no significant difference in age, sex, TNM staging, pathological type, adjuvant therapy between two groups (P>0.05). All patients underwent 6MV X-ray and 8-12 MeV electronic beam. The nasopharyngeal areas received dose of 72 Gy (range, 68 to 82 Gy), and neck positive lymph node regions received dose of 64 Gy (range, 60 to 70 Gy). RESULTS: The incidence rates of 2-3 degree early irradiation toxicity of oropharynx mucous membrane, salivary gland, and II- III degree late dry mouth were 23.2%, 26.1%, 37.7% in hypoxic RT group and 77.1%, 62.5%, 91.7% in regular RT group, respectively(P 0.05). The 1-, 3-, 5-, 7-year survival rates were 97.1%, 83.7%, 74.4%, 54.5% in hypoxic RT group and 97.9%, 86.8%, 70.2%, 54.7% in regular RT group, respectively (P>0.05). CONCLUSION: Hypoxia could alleviate irradiation toxicity and reduce complication rate of NPC patients. There is no significant difference between hypoxic RT and regular RT in tumor recurrence and metastasis and the survival rate of NPC. Further study is needed.