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目的初步评价分次立体定向放射治疗技术用于鼻咽癌三维适形调强放射治疗后残存病变推量治疗的临床价值。方法31例鼻咽癌三维适形调强放射治疗后病变残存的患者,应用德国Brain LAB公司生产的立体定向放射治疗系统进行推量照射。6MVX射线中位剂量16Gy(12~20Gy)。1~3个中心,参考剂量曲线选定为70%~90%。分割方式:4Gy/次,间隔1~3d。结果本组患者1、2、3年鼻咽局部控制率分别为97.0%,92.0%和86.0%;1、2、3年总生存率分别100%,94%和90%;1、2、3年无瘤生存率为97%,90%和82%。无其他特殊并发症发生。结论鼻咽癌初治患者在三维适形调强放疗后残存病变给与立体定向加量照射,能够取得较好的局部控制率和生存率。
Objective To evaluate the clinical value of fractionated stereotactic radiotherapy for the treatment of remnant lesions after three-dimensional conformal IMRT of nasopharyngeal carcinoma. Methods Thirty-one patients with residual disease of nasopharyngeal carcinoma after three-dimensional conformal IMRT were treated with Stereotactic Radiation Therapy System by Brain LAB of Germany. The median dose of 6MVX is 16Gy (12 ~ 20Gy). 1 to 3 centers, the reference dose curve selected as 70% to 90%. Segmentation: 4Gy / time, interval 1 ~ 3d. Results The local control rates of nasopharyngeal in patients at 1, 2 and 3 years were 97.0%, 92.0% and 86.0% respectively; the overall survival rates at 1, 2 and 3 years were 100%, 94% and 90% respectively; Annual tumor-free survival rates were 97%, 90% and 82%. No other special complications occurred. Conclusion The nasopharyngeal carcinoma in patients with nasopharyngeal carcinoma after three-dimensional conformal IMRT with stereotactic radiation exposure, can achieve better local control rate and survival rate.