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目的 随机比较鼻咽癌 7d/周连续加速放疗与常规放疗的近期疗效和副反应。方法 对 10 0例经病理学证实的初治鼻咽癌进行随机对照研究 ,连续加速放疗 (CAIR)组和常规放疗 (CR)组各 5 0例。CR组 6MVX线面颈联合野照射 36～ 4 0Gy后缩野避开脊髓加量至 70Gy。CAIR组 6MVX线周一至周五常规分割面颈联合野照射 ,总量 4 0Gy ;周六、周日用60 Co双侧耳前野 ,1次 /d ,1.8Gy/次 ,6MVX线面颈联合野照射结束后继续60 Co双侧耳前野连续照射。照射总量T1～T2期 6 340cGy,T3～T4期 6 880cGy。颈部周一至周五 6MVX线下颈部切线照射 ,CR组以后用电子线加量 ;CAIR组周六、周日用60 Co行全颈切线照射。治疗剂量均为 6 0～ 6 5Gy ,预防剂量为 5 0～ 5 5Gy。结果 放疗结束 3个月内根据临床及影像检查结果鼻咽部肿瘤CAIR组和CR组的CR率分别为 98%和 88% (P =0 .0 5 0 )。急性皮肤反应CAIR组和CR组的 1、2级和 3、4级分别为 88%、12 %和 92 %、8% (P =0 .5 0 0 ) ,急性黏膜反应分别为 74 %、2 6 %和 82 %、18% (P =0 .330 )。 2个组白细胞、血红蛋白、体重下降差异无统计学意义。结论 鼻咽癌患者进行 7d/周连续加速分割放疗 ,患者能够耐受 ,肿瘤近期局部控制率好 ,其对长期肿瘤局部控制率及生存率的影响有待进一步观察。
Objective To compare the short-term curative effects and side effects of continuous accelerated radiotherapy with conventional radiotherapy for nasopharyngeal carcinoma 7 days a week. Methods A randomized controlled study was performed on 100 newly diagnosed nasopharyngeal carcinomas confirmed by pathology and 50 cases in CAIR group and CR group. CR group 6MVX line face neck combined field irradiation 36 ~ 40GG after the field to avoid spinal dosage to 70Gy. CAIR group 6MVX line from Monday to Friday routinely divided facial and neck joint field irradiation, the total 4 0Gy; Saturday and Sunday with 60Co bilateral ear field, 1 / d, 1.8Gy / time, 6MVX line neck joint field Continuous irradiation of the 60Co bilateral ear and antrum was continued after the irradiation. The total irradiation dose was 6 340 cGy from T1 to T2, and 6 880 cGy from T3 to T4. Neck 6MVX neck line from Monday to Friday tangential line irradiation, CR group after the electronic line plus; CAIR group Saturday and Sunday 60Co line neck irradiation. The therapeutic dose was 60 ~ 65 Gy, and the preventive dose was 50 ~ 55 Gy. Results According to clinical and imaging findings within 3 months after radiotherapy, the CR rates of nasopharyngeal tumors in CAIR group and CR group were 98% and 88%, respectively (P = 0.060). Acute skin reactions Grade 1, 2, 3 and 4 of the CAIR group and the CR group were 88%, 12% and 92%, 8% (P = .500) respectively. Acute mucosal responses were 74% and 2 6% and 82%, 18% (P = .330). Two groups of white blood cells, hemoglobin, weight loss was no significant difference. CONCLUSIONS: Nasopharyngeal carcinoma patients are treated with accelerated accelerated radiotherapy for 7 days. Patients are able to tolerate these tumors. The recent local control rate of tumor is good. The effect on local control rate and survival rate of long-term tumors remains to be further studied.