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目的:探讨早期鼻咽癌肿瘤容积在综合治疗中的影响价值。方法:将60例经病理确诊的初治早期鼻咽癌患者随机分为对照组(A组)和治疗组(B组)。所有鼻咽癌患者行CT模拟定位,用计算机软件系统计算出大体肿瘤容积(GTV)。A组给予单纯常规放射治疗,B组采用常规分割放射治疗和PF方案同步化疗。结果:原发灶完全缓解率A组80.0%,B组96.7%,χ2=4.043,P=0.044。A组Ⅰ、Ⅱ级与Ⅲ、Ⅳ级急性皮肤反应分别为90.0%和10.0%,B组分别为80.0%和20.0%,χ2=1.176,P=0.278;A组急性黏膜炎反应分别为83.3%和16.7%,B组分别为66.7%和33.3%,χ2=2.222,P=0.136。结论:对GTV>25cm3的早期鼻咽癌同步放化疗是安全可行的,其远期并发症,如严重张口困难和后组颅神经损伤有待进一步观察和随访。
Objective: To explore the value of the early nasopharyngeal carcinoma volume in the comprehensive treatment. Methods: Sixty patients with early-stage nasopharyngeal carcinoma diagnosed by pathology were randomly divided into control group (group A) and treatment group (group B). All patients with nasopharyngeal carcinoma underwent CT simulation and gross tumor volume (GTV) was calculated using a computer software system. Group A was given routine radiotherapy, while Group B was treated with routine radiotherapy and PF regimen. Results: The complete remission rate of primary tumor was 80.0% in group A, 96.7% in group B, χ2 = 4.043, P = 0.044. The acute skin reactions of group Ⅰ, Ⅱ and Ⅲ, Ⅳ were 90.0% and 10.0% respectively in group A, 80.0% and 20.0% in group B, respectively, χ2 = 1.176, P = 0.278. The acute mucositis responses in group A were 83.3% And 16.7% in group B, 66.7% and 33.3% in group B respectively, χ2 = 2.222, P = 0.136. Conclusions: Simultaneous chemoradiotherapy for early nasopharyngeal carcinoma with GTV> 25cm3 is safe and feasible. Long-term complications such as severe mouth opening difficulties and cranial nerve injury in the latter group require further observation and follow-up.