鼻咽癌每周七天连续加速放疗的可行性研究报告

目的随机比较鼻咽癌7d／周连续加速放疗与常规放疗的近期疗效和副反应。方法对100例经病理学证实的初治鼻咽癌进行随机对照研究，连续加速放疗(CAm)组和常规放疗(CR)组各50例。CR组6MVX线面颈联合野照射36～40Gy后缩野避开脊髓加量至70Gy。CAm组6MVX线周一至周五常规分割面颈联合野照射，总量40Gy；周六、周日用60Co双侧耳前野，1次／d，1．8Gy／次，6MVx线面颈联合野照射结束后继续60Co双侧耳前野连续照射。照射总量T1～T2期6340cGy，T3～T4期6880cGy。颈部周一至周五6MVX线下颈部切线照射，CR组以后用电子线加量；CAIR组周六、周日用^60Co行全颈切线照射。治疗剂量均为60～65Gy，预防剂量为50～55Gyo结果放疗结束3个月内根据临床及影像检查结果鼻咽部肿瘤CAIR组和CR组的CR率分别为98％和88％(P=0．050)。急性皮肤反应CAm组和CR组的1、2级和3、4级分别为88％、12％和92％、8％(P=0．500)，急性黏膜反应分别为74％、26％和82％、18％(P=0．330)。2个组白细胞、血红蛋白、体重下降差异无统计学意义。结论鼻咽癌患者进行7d／周连续加速分割放疗，患者能够耐受，肿瘤近期局部控制率好，其对长期肿瘤局部控制率及生存率的影响有待进一步观察。

Feasibility of seven-day-per-week continual accelerated irradiation for nasopharyngeal carcinoma

Objective Objective To compared the toxicity and effect of conventional irradi ation (CR) and seven-day-per-week continual accelerated irradiation (CAIR) fo r nasopharyngeal carcinoma (NPC). Methods From February 2002 to June 2003, 100 pa tients with pathologically proved NPC were randomized into CR group (50 patients ) and CAIR group (50 patients). Radiotherapy in CR group was 2?Gy/fraction/day, 5 days/week with a total dose of 7000?cGy. Radiotherapy in CAIR was 2?Gy/fracti on/d ay from Monday to Friday and 1.8?Gy/fraction/day on Saturday and Sunday, to a t ot al dose of 6340?cGy in T1-2 and 6880?cGy in T3-4 lesions. Re sults All patients completed the treatment. According to physical and image examination, complete response rates in CAIR and CR were 98% and 88% (P=0.050). Acute skin toxicity rates in these two groups were 88% and 92% in grade 1-2, and 12% and 8%(P=0.500)in grade 3-4. Accordingly, the acute mucositis rates were 74% and 82%, 26% and1 8 %(P=0.330), respectively. There was no significant difference in leucocyte, he amoglobin and body weight reduction between CAIR and CR. Conclus ion Seven-day-p er-week continual accelerated irradiation for nasopharyngeal carcinoma is toler a ble with an excellent short term local control. Remote local control rate and su rvival rate await further follow-up.