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目的 :研究逐步递量加速超分割放射治疗 (EHART)局部晚期鼻咽癌的近期疗效和急性反应。方法 :1999年 4月— 2 0 0 0年 2月 6 4例T3— 4N0 M0 、KPS 80的鼻咽癌患者进入本研究 ,并随机分为常规分割放疗 (CFRT)组和EHART组 ,每组各 32例 ;CFRT组采用 2Gy 次 ,5次 周的方法 ,鼻咽靶区中心总剂量 6 8— 76Gy,中位数 70Gy ,34—38次 ,7— 8周 ;上颈部剂量 46— 5 6Gy ,2 3— 2 8次 ,5— 6周 ;EHART组每次分割剂量逐周递增 ,1、2、3、4、5周的分割剂量分别为 1.2Gy、1.3Gy、1.4Gy、1.5Gy和 1.6Gy,每天 2次 ,两次间隔时间 >6小时 ,每周 5天 ,鼻咽靶区中心总剂量 6 9.2— 71.6Gy ,中位数 70Gy,99— 10 2次 ,5周 ;上颈部剂量 46 .5— 5 4Gy ,6 5— 80次 ,4周。设野采用面颈联合野或面颈联合野 +面颈分野 ,均使用铅模不规则射野技术照射 ;放射源为6 0 Coγ射线和直线加速器的 6MV— 8MV光子线和 8MeV— 10MeV电子射线。结果 :EHART组口咽、喉咽急性放射反应明显较CFRT组严重 (P <0 .0 5 ) ;EHART组和CFRT组原发灶CR、PR率分别为 6 1.2 9%、38.71%和 6 7.74%、32 .2 6 % (P =0 .46 6 ) ,两组差别无显著意义。结论 :EHART能为大多数患者耐受 ;采用EHART和CFRT的方法病人近期疗效无明显差别 ,需扩大病例继续研究 ;?
Objective: To investigate the short-term curative effect and acute response of locally advanced nasopharyngeal carcinoma (ESCC) treated by escalating hyperfractionated radiation therapy (EHART). METHODS: From April 1999 to February 2004, 64 cases of NPC patients with T3-4N0 M0 and KPS80 were enrolled in this study and were randomly divided into routine radiotherapy (CFRT) group and EHART group, with each group 32 cases in each group. The CFRT group was treated with 2Gy times for 5 weeks. The total dose in the center of the nasopharyngeal target area ranged from 6 8 to 76 Gy, with a median of 70 Gy, 34 to 38 times and 7 to 8 weeks. The upper neck dose was 46 to 5 6Gy, 2 3- 2 8 times, 5-6 weeks; EHART group divided dose increased by one week, 1,2,3,4,5 weeks divided doses of 1.2Gy, 1.3Gy, 1.4Gy, 1.5Gy And 1.6Gy twice a day, two intervals of> 6 hours, 5 days a week, the total dose of the center of the nasopharyngeal target area 6 9.2-71.6Gy, the median 70Gy, 99-10 2 times, 5 weeks; the upper neck The dose of 46 .5-5 4Gy, 6 5-80 times, 4 weeks. Allotments were exposed to the irregular field technique of lead model with the combination of face-neck joint field or face-neck joint field + face-neck surgery. The 6MV-8MV photons and the 6MeV-10MeV electron rays with 60Coγ ray and linear accelerator . Results: The acute oropharyngeal and pharyngeal acute radiation response in EHART group was significantly more severe than that in CFRT group (P <0.05). The CR and PR rates in EHART group and CFRT group were 6 1.2 9%, 38.71% and 6 7.74 %, 32.26% (P = 0.46 6), no significant difference between the two groups. Conclusion: EHART can be tolerated in most patients. There is no significant difference between the two groups in EHART and CFRT.