上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

局部复发鼻咽癌的分次立体定向放射治疗

唐剑敏，侯艳丽，戴立言，白永瑞   

  1. 上海交通大学 医学院附属仁济医院放疗科， 上海 200127
  • 出版日期:2015-01-28 发布日期:2015-01-29
  • 作者简介:唐剑敏（1982—）， 男， 住院医师， 硕士; 电子信箱: tjmtjmtjm2006@126.com。

Fractionated stereotactic radiotherapy for treatment of locally recurrent nasopharyngeal carcinoma

TANG Jian-min, HOU Yan-li, DAI Li-yan, BAI Yong-rui   

  1. Department of Radiation Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2015-01-28 Published:2015-01-29

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摘要：

目的 评价采用伽玛射线立体定向放射治疗系统行分次立体定向放射治疗（FSRT）对放射治疗后复发鼻咽癌的疗效和不良反应。方法 应用FSRT对30例鼻咽癌患者分2组进行治疗，应用50%等剂量曲线，分次剂量均为2 Gy，每周连续治疗5次。其中复发推量组8例，中位处方剂量为15 Gy；单纯复发治疗组22例，中位处方剂量为40 Gy。结果 FSRT治疗后3个月，复发推量组患者完全缓解（CR）和部分缓解（PR）分别为87.5%（7/8）和12.5%（1/8），单纯复发治疗组CR和PR分别为77.3%（17/22）和22.7%（5/22）。全组病例随访时间10～70个月，中位随访时间为26个月。全组生存患者卡氏评分≥90者为95.2%（20/21）。复发推量组患者1年生存率和局部控制率分别为77.78％和77.78％，2年生存率和局部控制率分别为51.85％和77.78％；单纯复发治疗组患者1年生存率和局部控制率分别为90.23％和90.23％，2年生存率和局部控制率分别为82.71％和74.01％。结论 FSRT对放疗后复发鼻咽癌有良好的局部控制效果，值得临床进一步探讨。

关键词: 鼻咽肿瘤, 放射治疗, 立体定向放射治疗, 预后

Abstract:

Objective To evaluate the therapeutic effect and adverse reactions of fractionated stereotactic radiotherapy (FSRT) for the treatment of locally recurrent nasopharyngeal carcinoma after radiotherapy by the gamma ray stereotactic radiotherapy. Methods A total of 30 patients with recurrent nasopharyngeal carcinoma were divided into two groups (A group and B group) and treated by FSRT. The prescription dose at 50％ isodose line was 2 Gy each time and each patient consecutively underwent 5 treatments per week. The mean doses of A group (n=8) and B group (n=22) were 15 Gy and 40 Gy, respectively. Results The complete response (CR) and partial response (PR) rates of A group were 87.5% (7/8) and 12.5% (1/8) after being treated by FSRT for 3 months and the CR and PR rates of B group were 77.3% (17/22) and 22.7% (5/22). The follow-up time was 10-70 months and the median follow-up time was 26 months. The Karnofsky performance status scores for 95.2%（20/21） of the surviving patients were over 90. The one-year survival rate and local control rate of A group were 77.78% and 77.78% and two-year survival rate and local control rate were 51.85% and 77.78%. The one year survival rate and local control rate of B group were 90.23% and 90.23% and two-year survival rate and local control rate were 82.71% and 74.01%. Conclusion The local control effect of FSRT on locally recurrent nasopharyngeal carcinoma after
radiotherapy is good and it is worth further clinical studies.

Key words: nasopharyngeal carcinoma, radiotherapy, stereotactic radiotherapy, prognosis