鼻咽癌腔内热疗联合放疗的临床近期观察

Intracavitary Thermotherapy Combined with Radiotherapy for Nasopharyngeal Carcinoma

  • 摘要: 目的:探讨腔内热疗联合放疗治疗鼻咽癌的近期疗效、热增强比和不良反应。方法:将70例初治鼻咽癌患者按治疗方法随机分为两组:腔内热疗联合放疗组35例(热放组)和单纯放疗组35例(单放组)。热放组热疗采用915MHz微波热疗,肿瘤表面温度42℃~43℃,加热时间40分钟,每周1~2次,共4周。两组患者放疗方法相同。分别比较两组的近期疗效和不良反应,并计算热增强比。结果:热放组与单放组鼻咽癌原发灶的完全缓解率分别为65.7%、31.4%,有效率分别为97.1%、77.1%,有显著统计学意义;颈部淋巴结转移灶完全缓解率分别为87.5%、81.8%,有效率均为100%,无统计学意义。鼻咽肿瘤消退1/2和全消退的热增强比分别为1.68、1.39。结论:腔内热疗联合放疗治疗鼻咽癌原发灶优于单纯放疗,对颈部淋巴结转移灶未见优势。

     

    Abstract: Objective :To evaluate the clinical efficacy,thermal enhancement ratio,and toxicity of intracavitory thermotherapy with radiotherapy for patients with nasophaiyngeal carcinoma. Methods : Seventy untreated patients with nasopharyngeal carcinoma were divided into the combined group (intracavitaiy theimotheiapy plus radiotherapy) and the controlled group (radiotherapy alone) based on treatmental methods. The combined group was given intiacavitaiy hyperthermia with a 915MHz microwave hyperthemia unit. The surface temperature of nasopharyngeal tumor ranged from 42% to 43%. The warm-up time was 40 minutes, once or twice per week, 4 weeks in all. Radiotherapy was performed by 6MYX and 10MEVβ. The total dose for primary nasopharyngeal tumor and cervical metastatic cancer was 70 to 80Gy and 60 to 70Gy, respectively. A fractionated dose of 2Gy/fraction/day was delivered, with five fractions/ week. Results :The total remission rate for primary nasopharyngeal tumor in thermotherapy group and radiotherapy group was 65.7% and 31.4% and the effective rate was 97.1% and 77.1%, respectively. There was a significant difference in the comparion between the two; the total remission rate for cervical metastatic cancer was 87.5% and 81.8% and the effective rate was 100.0% and 100.0%, respectively. There was no statistical significance in the comparion. The thermal enhancement ratio of half shrink and disappearance of nasopharyngeal tumor was 1.68 and 1.39. Conclusions :Intracavitary thermotherapy plus radiotherapy is better than radiotherapy alone.

     

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