摘要
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 10 0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 (CAIR)组和常规放疗 (CR)组各 5 0例。CR组 6MVX线面颈联合野照射 36～ 4 0Gy后缩野避开脊髓加量至 70Gy。CAIR组 6MVX线周一至周五常规分割面颈联合野照射 ,总量 4 0Gy ;周六、周日用60 Co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60 Co双侧耳前野连续照射。照射总量T1～T2期 6 340cGy,T3～T4期 6 880cGy。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60 Co行全颈切线照射。治疗剂量均为 6 0～ 6 5Gy ,预防剂量为 5 0～ 5 5Gy。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 .0 5 0 )。急性皮肤反应CAIR组和CR组的 1、2级和 3、4级分别为 88%、12 %和 92 %、8% (P =0 .5 0 0 ) ,急性黏膜反应分别为 74 %、2 6 %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。
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.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2005年第2期73-76,共4页
Chinese Journal of Radiation Oncology
关键词
鼻咽癌
加速放疗
可行性
放射剂量
Nasopharyngeal neoplasms/radiotherapy
D ose fractionnation
Feasibility studies
