后程缩野加速超分割放疗联合化疗治疗Ⅲ和Ⅳa期鼻咽癌的临床研究

Later Course Field-in-field Accelerated Hyperfractionated Radiotherapy Combined with Chemotherapy for Stage Ⅲ and Ⅳa Nasopharyngeal Carcinoma

摘要: 目的　研究后程缩野加速超分割放疗联合化疗治疗Ⅲ和Ⅳa期鼻咽癌的疗效和毒副作用。方法　 178例Ⅲ和Ⅳa期鼻咽癌患者随机分为研究组和对照组, 均先诱导化疗两疗程, 而后研究组行常规分割放疗 4 0Gy加缩野加速超分割放疗至 70～ 76Gy, 对照组常规分割放疗 70Gy, 放疗后两组均再化疗两疗程。结果　肿瘤原发灶CR、PR率, 1、3年局部控制率和 3年无瘤生存率两组间有显著性差异 ;1、3年生存率和 3年累计远处转移率两组间无显著性差异 ;研究组Ⅱ～Ⅲ度急性放射性口咽黏膜反应发生率高于对照组。结论　后程缩野加速超分割放疗联合化疗提高了Ⅲ和Ⅳa期鼻咽癌的肿瘤消退率、局部控制率及无瘤生存率, 急性放射反应加重但可以耐受, 能否提高总生存率有待进一步观察

Abstract: Objective To evaluate the curative effects and side effects of later course field in field accelerated hyperfractionation radiotherapy combined with chemotherapy for stage Ⅲ and Ⅳa nasopharyngeal carcinoma(NPC). Methods 178 patients with Stage Ⅲ and Ⅳa NPC were divided into two groups randomly treated by later course field in field accelerated hyperfractionation radiotherapy combined with chemotherapy and conventional fractionation radiotherapy combined with chemotherapy respectively. Results The diffe...