摘要
目的研究大分割三维适形放疗治疗鼻咽复发鼻咽癌,了解相关放射损伤反应及疗效方法回顾分析我院2008-2013年间收治的鼻咽复发鼻咽癌患者153例,采用大分割三维适形放疗(3 Gy/次,5次/周,总量51-60 Gy,4周共17-20次),观察近期和远期损伤、KPS评分、近期和远期疗效.结果近期损伤中口腔黏膜、乏力治疗前与治疗结束时相比不同(P均<0. 05),远期放射损伤发生率分别为口干(95.4%)、耳聋(51.0%)、张口困难(79. 1%)、颌面部纤维化(33.3%)、放射性脑病(15.0%),治疗前与治疗结束时相比不同(P均<0.05),实际远期放射损伤口干(91.5%)、耳聋(50. 9%)、张口困难(76. 5%)、颌面部纤维化(32. 0%)、放射性脑病(14. 4%);治疗结束时与治疗后3个月对比患者KPS评分变化人数不同(P<0.05);治疗后1、3、6、9、12个月后局部控制率分别为29.4%、68.6%、79. 1%、83.7%、86.9%, 1个月后与3个月后、3个月后与6个月后对比不同(P<0.05);1、2、3、4、5年生存率分别为96. 1%.80. 4%,68.5%、57. 9%、51. 1%结论大分割三维适形放疗用于鼻咽复发鼻咽癌患者的近期疗效、远期疗效较好.局部控制率高,患者可耐受,安全性较好.
Objective To evaluate the clinical efficacy and safety of the hypofractionated three-dimensional conformal radiotherapy in the treatment of recurrent nasopharyngeal carcinoma.Methods Clinical data of 153 patients with recurrent nasopharyngeal carcinoma admitted to our hospital from 2008 to 2013 undergoing hypofractionated three-dimensional conformal radiotherapy (3 Gy for each time,5 times a week,a total dose of 51-60 Gy,17-20 times/4 weeks) were retrospectively analyzed.The short-and long-term radiation-induced injury,Karnofsky performance score (KPS),short-and long-term clinical efficacy were evaluated.Results For the short-term radiation-induced injury,the incidence of oral mucosa and fatigue significantly differed before and after treatment (both P<0.05).Regarding the long-term radiation-induced injury,the incidence of dry mouth (95.4%) and deafness (51.0%),difficulty in opening mouth (79.1%),maxillofacial fibrosis (33.3%) and radiation-induced encephalopathy (15.0%) significantly differed before and following treatment (all P< 0.05).The actual long-term radiation-induced injury included dry mouth (91.5%),deafness (50.9%),difficulty in opening mouth (76.5%),maxillofacial fibrosis (32.0%) and radiation-induced encephalopathy (14.4%).The number of patients with changes in the KPS scores significantly differed between the end of treatment and 3 months after treatment (P<0.05).The local control rates were 29.4%,68.6%,79.1%,83.7% and 86.9% at 1-,3-,6-,9-and 12-month after corresponding treatment,respectively.The local control rate significantly differed between 1 and 3 months,and between 3 and 6 months after treatment (both P<0.05).The 1-,2-,3-,4-and 5-year survival rates were calculated as 96.1%,80.4%,68.5%,57.9% and 51.1%,respectively.Conclusions Hypofractionated three-dimensional conformal radiotherapy is an efficacious and safe treatment of recurrent nasopharyngeal nasopharyngeal carcinoma,which yields relatively high short-and long-term clinical efficacy,high local control rate and well tolerance by the patie
作者
龙斌
周光华
杨新辉
施晓焱
龙君
Long Bin;Zhou Guanghua;Yang Xinhui;Shi Xiaoyan;Long Jun(Department of Oncology, The 921^th Hospital of PLA Joint Logistics Support Force/Second Affiliated Hospital ofHunan Normal University, Changsha 410003.,China;Department of Special Clinic. The 921^th Hospital of PLA Joint Logistics Support Force/Second Affiliated Hospital of Hunan Normal University, Changsha 410003,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2019年第3期173-179,共7页
Chinese Journal of Radiation Oncology
关键词
鼻咽肿瘤复发/三维适形放射疗法
放射疗法
大分割
放射损伤
治疗结果
Nasopharyngeal neoplasm recurrence/three-dimensional conformal radiotherapy
Radiotherapy, hypofractionated
Radiation-induced injury
Treatment outcome
