中华放射医学与防护杂志

何霞云,郭小毛,章真,等.鼻咽癌常规和超分割后加速放疗的疗效分析[J].中华放射医学与防护杂志,2013,33(4):392-395.HE Xia-yun,GUO Xiao-mao,ZHANG Zhen,et al.Efficacy of conventional radiotherapy and late course accelerated hyperfractionationated radiotherapy for nasopharyngeal carcinoma [J].Chin J Radiol Med Prot,2013,33(4):392-395

鼻咽癌常规和超分割后加速放疗的疗效分析

Efficacy of conventional radiotherapy and late course accelerated hyperfractionationated radiotherapy for nasopharyngeal carcinoma

投稿时间：2012-07-24

DOI：10.3760/cma.j.issn.0254-5098.2013.04.014

中文关键词: 鼻咽肿瘤常规分割超分割后加速放疗局部控制率

英文关键词:Nasopharyngeal carcinoma Conventional radiotherapy Late course accelerated hyperfractionated radiotherapy Control rate

基金项目:

作者	单位	E-mail
何霞云	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系
郭小毛	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系	shzlfl@gmail.com
章真	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系
叶明	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系
潘自强	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系
何少琴	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系
刘泰福	200032 上海, 复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系

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中文摘要:

目的比较鼻咽癌常规和超分割后加速放疗的局部控制率和生存率。方法 200例初治鼻咽癌患者根据计算机产生的随机数入常规组和超分割后加速放疗组,鼻咽原发灶采用⁶⁰Co γ射线或6 MV X射线外照射,常规组70 Gy/35次/7周,超分割后加速放疗组前4周采用超分割1.2 Gy/次,剂量为48 Gy/40次,后2周加速超分割1.5 Gy/次,剂量为30 Gy/20次,均为2次/d,间隔≥6 h,5 d/周。结果常规组99例中,远处转移25例、鼻咽复发25例、颈部复发16例;超分割后加速放疗组101例中,远处转移18例、鼻咽复发16例、颈部复发13例。常规组和超分割后加速组5年鼻咽局部控制率分别为75.9%、87.6% (χ²=4.066, P<0.05),总生存率分别为58.0%、74.1%(χ²=5.076, P<0.05),5年无远处转移率分别为74.1%、83.3%(P> 0.05),颈部局部控制率分别为81.5%、90.0%(P> 0.05)。结论与常规分割相比,超分割后加速放疗组提高了鼻咽局部控制率和总生存率,未减少颈部复发和远处转移率。

英文摘要:

Objective To compare the efficacy after conventional radiotherapy and late course accelerated fractionation radiotherapy for nasopharyngeal carcinoma (NPC). Methods A total of 200 NPC patients were enrolled and randomly assigned to conventional radiotherapy (CF) group with 99 cases or late course accelerated fractionation radiotherapy (LCAF) group with 101 cases,who received irradiation to ⁶⁰Co γ or 6 MV X-rays. In the CF group, the total dose of nasopharynx was 70 Gy/35 fractions at 2 Gy daily. In the LCAF group, for the first two-thirds of the treatment, two daily fractions of 1.2 Gy were given to the primary lesion and the total dose was 48 Gy/40 fractions. For the last one third of the treatment, the dose per fraction was increased to 1.5 Gy and the total dose was 30 Gy/20 fractions. Results There were 25, 16, 25 in CF group and 16, 13, 18 patients in LCAF group who had recurrence of nasophaynx, cervical lymph nodes, and distant metastasis, respectively. The 5-year nasopharyngeal control and overall survival rates was 75.9% and 87.6% in CF group (χ²=4.066, P<0.05), 58.0% and 74.1%(χ²=5.076, P<0.05) in LCAF group, respectively. Cervical lymph nodes local rates and distant metastases-free rates at 5 years were 81.5% and 90.0% in CF group(P> 0.05),74.1% and 83.3%(P> 0.05)in LCAF group, respectively. Conclusions Compared with CF, LCAF can improve nasopharyngeal control and overall survival rates, but there are no significant difference in the recurrence rates of cervical lymph nodes and distant metastasis.

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