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[目的]探讨Ⅰ、Ⅱ期鼻咽癌患者采用单纯外照射放疗与外照射加腔内联合放疗的长期疗效。[方法]前瞻性研究453例Ⅰ、Ⅱ期鼻咽癌患者,随机分为单纯外照射组297例,联合照射组156例;单纯外照射组采用低熔点铅挡块不规则野照射,常规照射,常规分割,总剂量为66～74Gy;联合照射组采用同样的外照射方法,总剂量给予58～62Gy,并给予15～20Gy腔内近距离放疗。[结果]单纯外照射组和联合照射组的5年鼻咽局控率分别为Ⅰ期92.86%、96.43%(P=0.35),Ⅱ期89.02%、94.53%(P=0.01);5年总生存率分别为Ⅰ期88.10%、92.86%(P=0.27),Ⅱ期81.18%、90.63%(P=0.03)。口干和张口困难的毒副反应联合照射组比单纯外照射组轻。[结论]Ⅰ、Ⅱ期鼻咽癌患者采用常规外照射联合腔内放疗相对单纯常规放疗有较好的疗效,并可减轻毒副反应。
[Objective] To investigate the long-term efficacy of external beam radiotherapy and external beam radiotherapy combined with radiotherapy in patients with stage I and II nasopharyngeal carcinoma. [Method] A total of 453 patients with stage Ⅰ and Ⅱ nasopharyngeal carcinoma were prospectively studied. They were randomly divided into 297 cases of external irradiation group and 156 cases of combined irradiation group. The external exposure group was treated with irregular field exposure with low melting lead lead block and conventional irradiation . The total dose was 66-74 Gy. The same external irradiation method was used in the combined irradiation group. The total dose was 58-62 Gy, and the intracavitary brachytherapy with 15-20 Gy was given. [Results] The five-year nasopharyngeal control rates in the simple external irradiation group and the combined irradiation group were 92.86%, 96.43% (P = 0.35), 89.02%, 94.53% (P = 0.01) The survival rates were 88.10% in stage Ⅰ, 92.86% in stage Ⅰ, 81.18% in stage Ⅱ, and 90.63% in stage Ⅱ (P = 0.03). Dry mouth and oral toxicity of the joint irradiation group than the simple external irradiation group light. [Conclusion] The patients with stage Ⅰ and Ⅱ nasopharyngeal carcinoma have better curative effect than routine conventional radiotherapy with conventional external beam radiation and intracavitary radiotherapy, and can reduce the side effects.