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目的 :观察后程加速超分割放疗和同步化疗治疗中晚期鼻咽癌的疗效。方法 :16 0例 III～ IV期鼻咽癌随机分为常规分割放疗组 (常规组 ) 5 4例、后程加速超分割放疗组 (后加速组 ) 5 8例及后程加速超分割放疗同步化疗组 (综合组 ) 4 8例。常规组照射 2 Gy/次 ,5次 /周 ,总剂量为 70 Gy。后加速组及综合组前 3.5周照射同常规组 ,然后开始照射 1.5 Gy/次 ,2次 /d,间隔 6 h,总量为 6 9Gy。综合组在整个放疗过程中加用化疗 ,每周 1次 ,每次用 DDP2 0～ 30 m g、 5 - Fu5 0 0 m g,静滴 ,共用 6～ 7次。结果 :放疗结束 6个月内鼻咽部肿瘤完全消退率 :后加速组为 6 4.7% ,综合组为 75 .7% ,常规组为 36 .0 % ,后加速组和综合组均明显高于常规组 (P <0 .0 5 )。 1,2 ,3年生存率 :后加速组为 93.1% ,85 .9% ,78.0 % ;综合组为 91.7% ,83.2 % ,78.7% ;常规组为 85 .2 % ,6 9.4% ,5 7.0 % ,后加速组及综合组明显高于常规组 (P <0 .0 5 ) ,而后加速组与综合组的差别无显著性意义 (P >0 .0 5 )。鼻咽部 1,2 ,3年局部控制率 :后加速组为 10 0 .0 % ,10 0 .0 % ,10 0 .0 % ;综合组为10 0 .0 % ,10 0 .0 % ,10 0 .0 % ;常规组为 10 0 .0 % ,92 .3% ,87.7% ,后加速组及综合组明显高于常规组 (P <0 .0 5 )。结论 :后程加速超
Objective: To observe the effect of late course accelerated hyperfraction radiotherapy and concurrent chemotherapy on advanced nasopharyngeal carcinoma. Methods: One hundred and sixty cases of stage III-IV nasopharyngeal carcinoma were randomly divided into routine radiotherapy group (n = 44), post-accelerated radiofrequency ablation group (n = 58) and accelerated radiofrequency ablation Chemotherapy group (integrated group) 48 cases. Conventional group irradiation 2 Gy / time, 5 times / week, the total dose of 70 Gy. The post-acceleration group and the combined group were exposed to the same routine as the normal group for 3.5 weeks and then began to irradiate 1.5 Gy / time, 2 times / d, 6 h intervals, a total of 6 9Gy. The combined group was given chemotherapy during the whole course of radiotherapy once a week, each time with DDP2 0 ~ 30 m g, 5 - Fu5 000 g, intravenous infusion, sharing 6 ~ 7 times. Results: The complete regression rate of nasopharyngeal tumors within 6 months after radiotherapy was as follows: post-acceleration group was 4.7%, comprehensive group was 75.7%, conventional group was 36.0%, post-acceleration group and comprehensive group were significantly higher than Conventional group (P <0.05). The 1,2 and 3-year survival rates were 93.1%, 85.9% and 78.0% in the post-acceleration group, 91.7%, 83.2% and 78.7% in the combined group and 85.2%, 64.4% and 5 7.0 in the conventional group %, Post-acceleration group and comprehensive group were significantly higher than those in the conventional group (P <0.05), but there was no significant difference between the post-acceleration group and the comprehensive group (P> 0.05). Nasopharyngeal 1, 2, 3-year local control rate: post-acceleration group was 100.0%, 100.0%, 100.0%; the combined group was 100.0%, 100.0% 100.0%, 92.3% and 87.7% in the conventional group, and significantly higher in the post-accelerated group and the combined group than in the conventional group (P <0.05). Conclusion: Accelerated after-stroke