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目的观察后程超分割治疗鼻咽癌的疗效及毒副反应。方法93例鼻咽癌患者被随机分为后程超分割治疗组(后超组47例)和常规分割对照组(常规组46例)。均先行面颈联合野常规分割对穿照射DT36Gy,20分次,4周,后超组缩野改用后程超分割照射,1.15~1.20Gy/次,2次/d,两次间隔时间6~8h,5d/周,鼻咽病灶总DT74.8~76.7Gy,54分次,7.5周完成。对照组缩野后常规照射2.0Gy/次,1次/d,鼻咽灶总DT69~72Gy,37~38分次,7.5周完成。颈部均为常规照射。结果后超组和常规组鼻咽部肿瘤消退率分别为100%、96%(χ2=2.10,P>0.05);1、3、5年肿瘤局部控制率分别为100%、98%、86%和100%、86%、54%(χ2=10.90,P<0.01);1、3、5年生存率分别为100%、94%、85%和98%、84%、63%(χ2=8.70,P<0.01)。两组放疗口腔黏膜反应无差别(χ2=1.00,P=0.800)。后超组复发率低于常规组(11%∶30%;χ2=5.60,P<0.05),而转移率无差别(12.8%∶28.3%;χ2=3.40,P>0.05)。结论鼻咽癌后程超分割的局部控制率及长期生存率明显高于常规组,而急性毒性反应及复发转移无明显差别。
Objective To observe the therapeutic effect and toxicity of late course hyperfractionation in the treatment of nasopharyngeal carcinoma. Methods Ninety-three patients with nasopharyngeal carcinoma were randomly divided into post-treatment hyperfractionation group (47 cases) and conventional group (46 cases). All were routinely combined neck and face surgery routinely divided into irradiation DT36Gy, 20 times, 4 weeks, after the super group shunt to use after the hyperfractionated irradiation, 1.15 ~ 1.20Gy / time, 2 times / d, two time interval 6 ~ 8h, 5d / week, total nasopharyngeal lesions DT74.8 ~ 76.7Gy, 54 times, 7.5 weeks to complete. Control group contracted after routine irradiation 2.0Gy / time, 1 / d, total nasopharyngeal DT69 ~ 72Gy, 37 ~ 38 times, 7.5 weeks to complete. The neck are routinely irradiated. Results The regression rates of nasopharyngeal tumors in super-group and conventional group were 100%, 96%, respectively (χ2 = 2.10, P> 0.05). The local control rates at 1, 3 and 5 years were 100%, 98% (Χ2 = 10.90, P <0.01). The 1, 3, 5-year survival rates were 100%, 94%, 85% and 98%, 84% and 63% , P <0.01). There was no difference in oral mucosal response between two groups (χ2 = 1.00, P = 0.800). The recurrence rate of the latter group was lower than that of the conventional group (11%: 30%; χ2 = 5.60, P <0.05), while the metastasis rate was no difference (12.8%: 28.3%; χ2 = 3.40, P> 0.05). Conclusion The local control rate and long-term survival rate of the late course of nasopharyngeal carcinoma after radiofrequency ablation are obviously higher than those of the conventional radiotherapy. There is no significant difference between acute toxicity and recurrence and metastasis.