加速分割放疗配合同期化疗治疗晚期鼻咽癌

背景与目的：临床研究表明,常规分割放射疗法治疗晚期鼻咽癌(nasopharyngeal carcinoma,NPC)的疗效不理想,采用非常规分割放疗以及放疗配合化疗治疗晚期NPC成为目前研究的重点。本研究的目的是探讨加速分割放疗以及同期化疗治疗晚期NPC的治疗效果和放射反应。方法：将我院1993年6月。1996年6月经病理检查证实、首程接受放射治疗的416例晚期NPC患者随机分为3组：加速分割放疗(accelerated fractionated radiotherapy,AF)组138例,每周照射6天,每天1次,每次180-190cGy,共46-49天,总剂量7400-7600cGy;加速分割放疗同期化疗(accelerated fractionated radiotherapy with concurrent chemotherapy,AFC)组139例,放疗方法同AF组,每周加顺铂和5-氟尿嘧啶各10次;常规分割放疗(conventional fractionated radiotherapy,CF)组139例,每周照射5天,每天1次,每次200cGy,总剂量7000--7500cGy。观察各组患者的局部复发率,5年生存率和放射反应。结果：随访超过5年,AF组和AFC组的局部复发率低于CF组,分别为16．7％

Accelerated fractionated radiotherapy with concurrent chemotherapy in advanced nasopharyngeal carcinoma

BACKGROUND &OBJECTIVE:Clinical studies showed there is no satisfying treatment efficacy of th e patients with advanced nasopharyn g eal carcinoma (NPC)using conventional fractionated ra diotherapy.It is important to treat the patients with advanced NPC using different fractionated radio therapy and radiotherapy combined with chem otherapy.The current study was desi g ned to evaluate the efficacy and radiation reactions of accelerated fractio nated radiotherapy with concurrent chemo therapy for advanced NPC patients.METHODS :From June 1993to June 1996,416patie nts patholog ically confirmed NPC who firstly underwent radiotherapy were divided into thre e g roups :accelerated fractionated r adiotherapy g roup(AF g roup,n=138,6fractions per week,one time per day,180-190cGy per day to a total dose of 7400-7600cGy ).Accelerated fractionated radioth erapy with concurrent chemotherapy g roup(AFC g roup,n=139,6fractions per week,one time p er day,180-190cGy per day to a total dos e of 7400-7600cGy,cisplatin and5-FU one time per week)and conventional fractionated radi otherapy g roup(CF g roup,n=139,5fractions per week,one time p er day,200cGy per day to a total dose of 7000-7600cGy ).The local recurrent rate,5-year su rvival rate,and acute radiation reactions in the three g roups were observed.RESULTS :All patients were followed up for more th an 5years.The local recurrent rates in AF g roup(16.7%)and AFC g roup(13.6%)were lower than that in CF g roup(27.3%)(P<0.05).The 5-year survival rates in AF g roup(53.6%)and AFC g roup(57.6%)were hig her than that in CF g roup(43.8%)(P<0.05).The acute radiation reactions in AF g rou p(47.1%)and AFC g roup(51.1%)were hig her than that in CF g roup(33.8%)(P<0.05).CONCLUSION:AF and AFC schedules are feasible in reducing l ocal recurrent rate and enhancing 5-year survival rate for patients with adva nced NPC.The acute radiation reactions of the AF and AFC g roups are tolerable.