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目的评价不同射野放射治疗无口咽侵犯的T1～2N0鼻咽癌的临床疗效。方法将56例T1～2N0M01992年福州分期鼻咽癌病人随机分为面颈联合野组(A组)和面颈分野组(B组)。A组先设面颈联合野和下颈切线野,均照射36Gy后改双耳前野24Gy,鼻前野8～10Gy和颈前切线野14Gy;B组设置双耳前野60Gy,鼻前野8～10Gy,颈前切线野50Gy。结果放疗结束时,鼻咽原发灶消退率A组和B组分别为96.4%和92.9%,两组无显著差异。A,B两组病人5年总生存率均为75%。面颈分野组1例发生放射性颈脊髓损伤,但是研究组在治疗中较对照组减少了放射性咽喉炎及粘膜反应。对照组3例发生放射性颞颌关节损伤,其中1例为3级损伤。对照组26例发生放射性唾液腺受损口干发生率为92.9%,其中10例为2级损伤,远远高于治疗组的89.3%,5例为2级损伤,但由于病例少在统计学上无显著性差异,对此需进一步观察。结论无口咽侵犯的T1～2N0鼻咽癌病人选用面颈联合野或面颈分野,生存率无显著差异,远期放射损伤情况面颈分野体现一定的优势。
Objective To evaluate the clinical efficacy of radiotherapy for orogenic non-orogenic carcinoma of T1 ~ 2N0 nasopharyngeal carcinoma. Methods Fifty-six patients with T1 ~ 2N0M0 in 1992 were divided into two groups: group C (group A) and face-neck group (group B). In group A, the frontal-neck joint field and the lower neck tangential field were first set up, and the anterior frontal area 24 Gy, anterior nasal area 8 ~ 10Gy and anterior cervical anterior 14Gy area were irradiated after 36 Gy irradiation. In group B, the anterior frontal area 60 Gy and anterior nasal area 8 ~ 10 Gy, Cervical tangent field 50Gy. Results At the end of radiotherapy, the regression rates of primary nasopharyngeal lesions in group A and group B were 96.4% and 92.9%, respectively, with no significant difference between the two groups. The 5-year overall survival rates of patients in groups A and B were both 75%. Radiological cervical spinal cord injury occurred in 1 case of face-neck subgroups, but the study group reduced radiation laryngopharyngitis and mucosal response compared with the control group. In the control group, 3 cases had radioactive temporomandibular joint injury, of which 1 case was Grade 3 injury. In the control group, the incidence of dry mouth damage of radioactive salivary glands was 92.9% in 26 patients, of which 10 were grade 2 lesions, which was much higher than 89.3% of the treated group and 5 of grade 2 lesions, but the cases were less statistically No significant difference, which needs further observation. Conclusion There is no significant difference in the survival rate of patients with or without oral or pharyngeal invasion of T1 ~ 2N0 nasopharyngeal carcinoma in terms of face-neck joint field or face-neck separation. The long-term radiation injury situation of face and neck represents some advantages.