郑乃莹, 莫志文, 史建军, 邓敬峰, 梁艳芳, 黄中, 邵汛帆. Ⅰ/Ⅱ期鼻咽癌外照射后残留后装推量的疗效分析[J]. 中国肿瘤临床, 2012, 39(19): 1440-1442. DOI: 10.3969/j.issn.1000-8179.2012.19.013
引用本文: 郑乃莹, 莫志文, 史建军, 邓敬峰, 梁艳芳, 黄中, 邵汛帆. Ⅰ/Ⅱ期鼻咽癌外照射后残留后装推量的疗效分析[J]. 中国肿瘤临床, 2012, 39(19): 1440-1442. DOI: 10.3969/j.issn.1000-8179.2012.19.013
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Naiying ZHENG, Zhiwen MO, Jianjun SHI, Jingfeng DENG, Yanfang LIANG, Zhong HUANG, Xunfan SHAO. Long-term Therapeutic Effect of Brachytherapy Boost Treatment for Patients with Locally Persistent StageⅠ/ⅡNasopharyngeal Carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(19): 1440-1442. DOI: 10.3969/j.issn.1000-8179.2012.19.013
Citation: Naiying ZHENG, Zhiwen MO, Jianjun SHI, Jingfeng DENG, Yanfang LIANG, Zhong HUANG, Xunfan SHAO. Long-term Therapeutic Effect of Brachytherapy Boost Treatment for Patients with Locally Persistent StageⅠ/ⅡNasopharyngeal Carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(19): 1440-1442. DOI: 10.3969/j.issn.1000-8179.2012.19.013
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Ⅰ/Ⅱ期鼻咽癌外照射后残留后装推量的疗效分析

Long-term Therapeutic Effect of Brachytherapy Boost Treatment for Patients with Locally Persistent StageⅠ/ⅡNasopharyngeal Carcinoma

    摘要
  • 摘要:
      目的  研究Ⅰ/Ⅱ期鼻咽癌常规外照射后2天内鼻咽纤维镜下可疑残留者使用后装推量是否可以改善疗效。
      方法  根据福州92分期分为Ⅰ/Ⅱ期的患者281例, 经首程常规根治量放疗完成后2天内, 影像学检查提示可疑残留病灶的患者35例行后装治疗作为联合照射组, 选取根治量放疗后完全缓解未推量的作为对照组(单纯外照射组)246例, 联合照射组采用后装推量10~12Gy/2F/6~8D。
      结果  两组患者治疗后的5年生存情况联合照射组鼻咽癌复发1例, 死亡2例, Ⅰ、Ⅱ期鼻咽癌的5年总的生存率分别为100%、92.3%。单纯外照射组鼻咽复发17例, 死亡41例, Ⅰ、Ⅱ期鼻咽癌患者的5年总的生存率分别为90.1%和80.6%(P=0.042), 联合照射组鼻咽5年局控率为97.1%, 单纯外照射组鼻咽局控率为93.3%(P=0.036), 两组毒副作用均可耐受。
      结论  对早期鼻咽癌常规外照射后影像学可疑残留者, 及早行后装推量治疗可以提高局控率及生存率, 患者可耐受。

     

    Abstract:
      Objective  To evaluate the long-term efficacy of external irradiation plus intracavitary brachytherapy in stageⅠ/Ⅱnasopharyngeal carcinoma(NPC).
      Methods  A total of 281 patients with stageⅠ/ⅡNPC were given radiotherapy to the nasopharynx lesion by a 66-70 Gy external beam.Nasopharyngofiberscopy was performed within 2 days after completion of the primary external radiation therapy(ERT).Among the patients, 35 who underwent endoscopy and were found to have highly suggestive residual tumors received high-dose-rate intracavitary brachytherapy(combination group).They were then compared with 246 patients treated with ERT alone (simplex group).
      Results  Within a 5 year follow-up period, in the combination group, 1 patient had tumor relapse at the nasophaynx and 2 patients died: the five-year overall survival rates were 100%for stageⅠpatients and 92.3%for stageⅡpatients.In the simplex group, 17 patients had tumor relapse at the nasopharynx and 41 patients died: the five-year overall survival rates were 90.1%for stageⅠpatients and 80.6%for stageⅡpatients(P = 0.042).The five-year local control rates were 97%for the combination group and 93.3% for the simplex group(P = 0.036).The adverse events in the combination group were tolerable.
      Conclusion  NPC patients have highly suggestive residual tumors as revealed by endoscopy can be effectively treated with brachytherapy.Brachytherapy boost treatment can improve the local control and overall survival rates.

     

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