当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
18期
1-2
,共2页
李金伟%王蓉%肖海%吴伟%张群贵
李金偉%王蓉%肖海%吳偉%張群貴
리금위%왕용%초해%오위%장군귀
鼻咽癌%放射治疗%分次剂量%同期化疗%近期疗效
鼻嚥癌%放射治療%分次劑量%同期化療%近期療效
비인암%방사치료%분차제량%동기화료%근기료효
Nasopharygeal neoplasms%Radiotherapy%Dose fractionation%Concurrent chemotherapy%Recent efficacy
目的：观察鼻咽癌后程加速超分割的近期疗效。方法选取120例局部晚期鼻咽癌患者，随机分为后程加速超分割组（研究组）和常规分割组（对照组）（n=60），2组均行同期顺铂化疗。2组开始均常规分割，50 Gy/25次后，研究组鼻咽每天照射2次，每次1.5 Gy，颈部CTV 1（Clinic Target Volume 1）上午照射1.8～2.0 Gy，GTVnd（Gross Tumour Volume nord）下午照射1.0～1.2 Gy，间隔6 h以上，鼻咽总剂量71～73 Gy，颈部CTV 1至59～60.8 Gy，GTVnd至65～68 Gy；对照组鼻咽及颈部仍常规分割，鼻咽剂量70～74 Gy，CTV 1至60 Gy，GTVnd至66～68 Gy。结果研究组、对照组放疗结束时、放疗后3、6个月鼻咽控制率分别为91.7%、95.0%、96.7%及78.3%、80.0%、83.3%（P＜0.05），颈部控制率分别为93.3%、96.7%、98.3%及80.0%、86.7%、86.7%。（P＜0.05）。研究组耳及口咽黏膜2、3级急性放射损伤增加较明显（50%vs 30%及53%vs 35%，均P＜0.05），但均能耐受。结论后程加速超分割并同期化疗能提高局部晚期鼻咽癌的原发灶及颈部淋巴结局控率，耐受性好。
目的：觀察鼻嚥癌後程加速超分割的近期療效。方法選取120例跼部晚期鼻嚥癌患者，隨機分為後程加速超分割組（研究組）和常規分割組（對照組）（n=60），2組均行同期順鉑化療。2組開始均常規分割，50 Gy/25次後，研究組鼻嚥每天照射2次，每次1.5 Gy，頸部CTV 1（Clinic Target Volume 1）上午照射1.8～2.0 Gy，GTVnd（Gross Tumour Volume nord）下午照射1.0～1.2 Gy，間隔6 h以上，鼻嚥總劑量71～73 Gy，頸部CTV 1至59～60.8 Gy，GTVnd至65～68 Gy；對照組鼻嚥及頸部仍常規分割，鼻嚥劑量70～74 Gy，CTV 1至60 Gy，GTVnd至66～68 Gy。結果研究組、對照組放療結束時、放療後3、6箇月鼻嚥控製率分彆為91.7%、95.0%、96.7%及78.3%、80.0%、83.3%（P＜0.05），頸部控製率分彆為93.3%、96.7%、98.3%及80.0%、86.7%、86.7%。（P＜0.05）。研究組耳及口嚥黏膜2、3級急性放射損傷增加較明顯（50%vs 30%及53%vs 35%，均P＜0.05），但均能耐受。結論後程加速超分割併同期化療能提高跼部晚期鼻嚥癌的原髮竈及頸部淋巴結跼控率，耐受性好。
목적：관찰비인암후정가속초분할적근기료효。방법선취120례국부만기비인암환자，수궤분위후정가속초분할조（연구조）화상규분할조（대조조）（n=60），2조균행동기순박화료。2조개시균상규분할，50 Gy/25차후，연구조비인매천조사2차，매차1.5 Gy，경부CTV 1（Clinic Target Volume 1）상오조사1.8～2.0 Gy，GTVnd（Gross Tumour Volume nord）하오조사1.0～1.2 Gy，간격6 h이상，비인총제량71～73 Gy，경부CTV 1지59～60.8 Gy，GTVnd지65～68 Gy；대조조비인급경부잉상규분할，비인제량70～74 Gy，CTV 1지60 Gy，GTVnd지66～68 Gy。결과연구조、대조조방료결속시、방료후3、6개월비인공제솔분별위91.7%、95.0%、96.7%급78.3%、80.0%、83.3%（P＜0.05），경부공제솔분별위93.3%、96.7%、98.3%급80.0%、86.7%、86.7%。（P＜0.05）。연구조이급구인점막2、3급급성방사손상증가교명현（50%vs 30%급53%vs 35%，균P＜0.05），단균능내수。결론후정가속초분할병동기화료능제고국부만기비인암적원발조급경부림파결국공솔，내수성호。
Objective To observe the recent effect and complications for locally terminal nasopharyngeal carcinoma(NPC)with the method of the late course accelerated hyperfraction joint concurrent chemotherapy. Methods 120 cases who were locally terminal with NPC were divided into the late course accelerated hyperfraction(Study group)and conventional fraction(Control group),60 cases in each group,each case was irradiated conventional fraction initially,after 50 Gy/25 f,The nasopharygeal of the study group was irradiated 2 times per day with 1.5 Gy,The positive area of cervical lymph nodes area(CTV 1)were irradiated with 1.8-2.0 Gy in morning,the lymph nodesof positive (GTVnd) were irradiated with 1.0-1.2 Gy at afternoon,interval of more than 6 hours,with the total doses of nasopharygeal were 71-73 Gy,the total doses of CTV1 were 59-60.8 Gy, GTVnd were 65-68 Gy;The nasopharygeal and the cervix of the control group were irradiated with the conventional method,The nasopharygeal were irradiated to 70-74 Gy,CTV 1 to 60 Gy,GTVnd to 66-68 Gy. All patients during radiotherapy underwent concurrent cisplatin chemotherapy. Results The nasopharygeal control rates of the study group and the control group were 91.7%,95.0%,96.7%and 78.3%,80.0%,83.3%(P<0.05)at the end of radiotherapy and 3 months later and 6 months later respectively,The neck control rates of the two groups were 93.3%,96.7%,98.3%and 80.0%,86.7%,86.7%(P<0.05)respectively.The incidences and degrees of the acute radiation injury of the ears and the oropharynx mucous membranes increased significantly(P<0.05), but all can tolerate. Conclusion The method of the late course accelerated hyperfraction joint concurrent chemotherapy can improve the control rate of the local terminal nasopharyngeal primary tumor and the cervical lymph node ,and the patient’s tolerance is good.
