中晚期鼻咽癌后程加速超分割放疗的近期疗效观察

目的：观察鼻咽癌后程加速超分割放射治疗（LCAF）的近期疗效和毒性反应。方法：60例鼻咽癌患者随机分为常规分割放射治疗（CF）组和LCAF组，CF组患者鼻咽部和颈部全程行常规分割放疗，LCAF组先常规放疗36Gy，25d，然后采用LCAF照射33～35Gy，16～18d，每日2次，间隔时间6h，鼻咽部剂量为65～75Gy。有颈部淋巴结转移者颈部照射剂量68～74Gy，无颈部淋巴结转移者预防照射剂量55～60Gy。放射治疗结束时、放疗结束后3个月复查鼻咽部CT、纤维鼻咽镜、颈部CT和／或B超检查，综合评价放疗疗效。结果：放疗结束后3个月LCAF组肿瘤全部消退率为79，31％4CF组为54．84％，差异有统计学意义（χ^2=4．0380，P〈20．05），LCAF组与CF组比较，Ⅰ、Ⅱ、Ⅲ度急性放射反应发生率差异无统计学意义（χ^2=0．2020，P〉0．05）。结论：LCAF放射治疗可以改善中晚期鼻咽癌的局部控制率，而不增加急性放射反应。

Preliminary report of late course accelerated hyperfractionated radiotherapy for advanced nasopharyngeal carcinoma

Objective: To evaluate the immediate response and radio toxicity of late course accelerated hyper-fractionated radiotherapy for advanced nasopharyngeal carcinoma. Methed: From June 2001 to December 2002, 60 patients with advanced nasopharyngeal carcinoma were devided into conventional fractionation (CF) and late course accelerated hyperfractionated radiotherapy (LCAF) groups. Thirty-one patients in CF group received conventional radiotherapy. Twenty-night patients in LCAF group were treated with the same fractionation as CF group until the dose of 36Gy, and then followed by late course accelerated hyper-fractionated radiotherapy:1. 2-1. 3 Gy/f, twice daily with 6-8 hour interval between the two fractions, to the total dose of 65-75Gy in 41-47days. Results: The complete response rate was 79. 31% in the LCAF group and 54. 84% in the CF group after 3 months of radiotherapy. The difference is significant between two groups, but without finding any significant difference in acute radio toxicity . Conclusion: LCAF radiotherapy can improve local control of nasopharyngeal carcinoma and does not increase the acute radio toxicity.