CAJ | 학술논문

目的：比较鼻咽癌患者调强放疗与适形放疗的疗效和副反应，以及对预后和生存质量的影响。方法2005年1月至2007年10月，我院共186例初诊且无远处转移的鼻咽癌患者接受全程放射治疗，调强放疗组89例，适形放疗组97例，两组病例均采用Phicips高能直线加速器治疗，选择能量为6MV-X射线。适形放疗组分4段设野，DT2Gy/次，1次/d ，5次/周，根治剂量DT70～72Gy/35～36次/7～8周，预防剂量DT50Gy/25次/5周。调强放疗采用7野共面照射，靶区处方剂量GTVnx ：69．96Gy～73．92Gy ，GTVnd：69．96Gy ，PTV1：60．06Gy ，PTV2：50．96Gy。全疗程33次，1次/d ，5次/周。放疗过程中每两周执行1次实时验证。结果两组病例均顺利完成全程放疗，适形放疗组5年局部控制率、总生存率分别为90．7％、85．5％；调强放疗组5年局部控制率、总生存率分别为91％、86．5％。调强放疗组口干和张口困难发生率和损伤程度明显低于适形放疗组。结论调强放疗组的副反应发生率和发生程度较适形放疗组明显降低，能提高鼻咽癌患者生活质量。
목적：비교비인암환자조강방료여괄형방료적료효화부반응，이급대예후화생존질량적영향。방법2005년1월지2007년10월，아원공186례초진차무원처전이적비인암환자접수전정방사치료，조강방료조89례，괄형방료조97례，량조병례균채용Phicips고능직선가속기치료，선택능량위6MV-X사선。괄형방료조분4단설야，DT2Gy/차，1차/d ，5차/주，근치제량DT70～72Gy/35～36차/7～8주，예방제량DT50Gy/25차/5주。조강방료채용7야공면조사，파구처방제량GTVnx ：69．96Gy～73．92Gy ，GTVnd：69．96Gy ，PTV1：60．06Gy ，PTV2：50．96Gy。전료정33차，1차/d ，5차/주。방료과정중매량주집행1차실시험증。결과량조병례균순리완성전정방료，괄형방료조5년국부공제솔、총생존솔분별위90．7％、85．5％；조강방료조5년국부공제솔、총생존솔분별위91％、86．5％。조강방료조구간화장구곤난발생솔화손상정도명현저우괄형방료조。결론조강방료조적부반응발생솔화발생정도교괄형방료조명현강저，능제고비인암환자생활질량。
Objective To compare with efficacy ,side effects ,the prognosis and quality of life in patients of nasopharynx cancer treated with intensity-modulated radiation therapy (IMRT ) and three-dimensional conformal radiation therapy (3-DCRT ) .Methods 186 patients with newly diagnosed pa-tients of nasopharynx cancer without distant metastasis were treated with radiation therapy in our hos-pital from January 2005 to October 2007 .The patients were divided into two group which were inten-sity-modulated radiation therapy group (89 cases) and conformal radiotherapy group (97 cases) .The patients were treated with Phicips high-energy linear accelerator with 6 MV X rays .The patients in 3-DCRT group were treated with four-field (10Gy ,70-72Gy or 50Gy ) .Coplanar beams of intensity modulated radiation therapy to be used was 7 (GTVnx :69 .96Gy~73 .92Gy ,GTVnd:69 .96Gy ,PTV1 :60 .06Gy ,PTV2 :50 .96Gy ,33 numbers ,five times a week) .Results The two groups of patients were successfully complete radiotherapy .And the conformal radiotherapy group of 5-year local control rate , and overall survival rates were 90 .7% and 85 .5% .The 5-year local control rate ,overall survival rate were 91% and 86 .5% .The incidence of xerostomia and trismus ,and oral injuries in IMRT group was significantly lower than the group of conformal radiotherapy .Conclusion The incidence and degree of side effects in IMRT group was significantly lower than 3-DCRT group ,IMRT can improve the quali-ty of life of patients with nasopharyngeal carcinoma .