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目的:本研究为前瞻性研究,对鼻咽癌常规放射治疗与常规放疗加后程三维适形放射治疗进行比较,比较两者疗效、晚期并发症的差异。方法:45例常规放疗加后程三维适形放射治疗患者(治疗组)采用多个共面或非共面野等中心三维适形治疗。47例常规放射治疗患者(对照组)采用面颈联合野等常规治疗。结果:三维适形放疗组5年肿瘤局控率(TCP)为88.8%(40/45),常规放疗组5年肿瘤局控率(TCP)为91.4%(43/47);三维适形放疗组5年生存率71.1%(32/45);常规放疗组5年生存率74.4%(35/47),两组之间总有效率无明显差异(P>0.05)。晚期反应如涎腺功能、颞颌关节功能,后程三维适形放疗好于对照组,两组比较有显著差异(P<0.05)。结论:采用常规放疗加后程三维适形放射治疗在保证局控率同时,可有效保护敏感器官,减轻放疗不良反应,提高患者生活质量。
OBJECTIVE: This study was a prospective study comparing conventional radiation therapy with conventional radiotherapy plus 3-D conformal radiotherapy of nasopharyngeal carcinoma to compare the efficacy and late complications of the two. Methods: Forty-five patients undergoing conventional radiotherapy plus posterior three-dimensional conformal radiotherapy (treatment group) were treated with multiple conformal or non-coplanar isocenters. 47 cases of conventional radiotherapy patients (control group) face and neck joint field and other routine treatment. Results: The TCP control rate (TCP) was 88.8% (40/45) at 5 years in three-dimensional conformal radiotherapy group and 91.4% (43/47) at 5 years in conventional radiotherapy group. The three-dimensional conformal radiotherapy The 5-year survival rate was 71.1% (32/45) in the conventional radiotherapy group and 74.4% (35/47) in the conventional radiotherapy group. There was no significant difference in the total effective rate between the two groups (P> 0.05). Late response, such as salivary gland function, temporomandibular joint function, posterior three-dimensional conformal radiotherapy better than the control group, the two groups were significantly different (P <0.05). Conclusion: Conventional radiotherapy plus posterior three-dimensional conformal radiotherapy can ensure the control rate at the same time, which can effectively protect sensitive organs, reduce the adverse reactions of radiotherapy and improve the quality of life of patients.