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目的比较计划性外照射加腔内近距离治疗和单纯外照射对早期鼻咽癌的５年局部控制率、５年生存率以及后遗症。材料与方法自１９９０年３月到１９９６年１１月，对１２４例Ｔ１、Ｔ２初治的鼻咽癌患者进行了前瞻性随机分组研究。男性８６例，女性３８例。中位年龄４７岁。全部病例均经病理证实，除１例为腺鳞癌外，余均为低分化鳞癌，Ｋａｒｎｏｆｓｋｙ评分均≥８０分，中位随诊期：６２个月（５～８４个月）。全组外照射采用６～８ＭＶ－Ｘ线，腔内近距离治疗采用高剂量率１９２Ｉｒ微源。随机分组方法：全部病例先采用常规外照射技术（面颈联合野加耳前野），ＣＴ或ＭＲＩ提示咽旁间隙未受侵者外照射剂量予ＤＴ５０～６０Ｇｙ，咽旁间隙受侵者予ＤＴ５０～７０Ｇｙ。然后行鼻咽ＣＴ或ＭＲＩ检查，对于咽旁间隙肿瘤消退满意的病例，采用信封法分为单纯外照射组（ＲＴ）６０例和计划性外照射加腔内近距离治疗组（ＲＢ）６４例。ＲＴ组则继续外照射至根治剂量，７０～８６Ｇｙ（中位剂量７５Ｇｙ）。ＲＢ组则在休息１周后采用腔内近距离治疗加量。每周治疗１次，除７例因在外照射至鼻咽ＤＴ４０～５５Ｇｙ时肿瘤已完全消失的患者仅行１次腔内治疗外，余５７例均接受了２～３次腔内近距离治疗。剂量参考点?
Objective To compare the 5-year local control rate, 5-year survival rate and sequelae of planned external irradiation combined with brachytherapy and simple external irradiation for early stage nasopharyngeal carcinoma. Materials and Methods From March 1990 to November 1996, a prospective randomized study of 124 patients with T1 and T2-treated nasopharyngeal carcinoma. 86 males and 38 females. The median age is 47 years old. All the cases were confirmed by pathology. All cases were poorly differentiated squamous cell carcinoma except one case of adenosquamous carcinoma. The Karnofsky score was ≥80 and the median follow-up period was 62 months (range 5-84 months). The whole group of external irradiation with 6 ~ 8MV-X line, intracavitary brachytherapy using high-dose rate 192Ir micro-source. Random grouping method: All cases were treated with conventional external irradiation (facial and neck joint wild plus ear field), CT or MRI showed that the external parapharyngeal space was not invaded external dose to DT50 ~ 60Gy, parapharyngeal space invaders to DT50 ~ 70Gy. And then nasopharyngeal CT or MRI examination, the parapharyngeal space tumor satisfaction regression cases, using envelope method was divided into simple external beam group (RT) 60 cases and planned external beam plus intracavitary brachytherapy group (RB) 64 cases . RT group continued to external irradiation to the radical dose, 70 ~ 86Gy (median dose of 75Gy). RB group is resting 1 week after the use of intracavitary brachytherapy. Weekly treatment, except for 7 cases of external luminal DT40 ~ 55Gy nasopharyngeal tumor has completely disappeared only one endovascular treatment, the other 57 patients received 2 or 3 intracavitary brachytherapy. Dose reference point?