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目的 :探讨外照射加高剂量率腔内后装 (腔内后装 )与单纯外照射治疗早期鼻咽癌的疗效及放射损伤发生率。方法 :将 5 6例Ⅰ、Ⅱ期鼻咽癌患者随机分为外照射加腔内后装 (综合治疗组 )及单纯外照射 (对照组 )两组 ,前者鼻咽部外照射剂量DT5 6～ 6 0Gy ,腔内后装在放疗结束前 2周进行 ,每周 1次 ,每次 8Gy ,总剂量16Gy ;后者外照射剂量DT6 8～ 72Gy。结果 :综合治疗组及对照组肿瘤局部控制率分别为 76 .7%及 73.1% (P>0 .0 5 ) ;综合治疗组和对照组 5及 7年生存率分别是 73.3%、6 3.3%及 76 .9%、6 1.5 % (P >0 .0 5 ) ;张口困难(门齿距 <3cm)发生率综合治疗组和对照组分别为 6 .7%及 2 6 .9% ,前者明显低于后者 ,差别具有显著性 (P<0 .0 5 )。结论 :虽然综合治疗组及对照组的肿瘤局部控制率比较无明显差异 ,但是综合治疗可以降低外照射剂量 ,减少放射损伤 ,提高患者放射治疗的生活质量。
Objective: To investigate the efficacy and radiation injury of nasopharyngeal carcinoma treated with external irradiation plus high dose rate intracavity afterloading (intracavitary afterloading) and simple external irradiation. Methods: Fifty-six patients with stage Ⅰ and Ⅱ nasopharyngeal carcinoma were randomly divided into two groups: external beam irradiation plus intracavitary afterloading (combination therapy group) and external beam irradiation alone (control group) 6 Gy, intracavitary after the end of radiotherapy in the first two weeks, once a week, each 8Gy, a total dose of 16Gy; the latter dose of DT6 8 ~ 72Gy. Results: The local control rates of the combined treatment group and the control group were 76.7% and 73.1% (P> 0.05) respectively. The 5- and 7-year survival rates of the combined treatment group and control group were 73.3% and 63.3% And 76.9%, respectively, 6 1.5% (P> 0.05). The incidence of mouth opening (<3cm) was 6.7% in the comprehensive treatment group and 26.9% in the control group, the former was significantly lower In the latter, the difference was significant (P <0.05). Conclusion: Although there is no significant difference in the local control rate of the tumors in the comprehensive treatment group and the control group, the comprehensive treatment can reduce the external radiation dose, reduce the radiation injury and improve the quality of life of the patients undergoing radiotherapy.