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目的观察福莫斯汀联合三维适形放疗(3D CRT)对局部复发老年鼻咽癌的放射增敏作用。方法80例复发者均为首程放疗后达基本痊愈或明显好转一段时间(>6个月)后又出现鼻出血及回缩性血涕、鼻塞、头痛、耳鸣和听力下降等情况恶化的临床症状,经病理检查确诊为复发,随机分为研究组和对照组,每组40例。研究组福莫斯汀208mg/m2用4ml安剖瓶内的无菌乙醇溶液溶解后,再加入到250ml 5%等渗葡萄糖稀释后静脉输入,输入结束后60min内放疗,放疗均采用西门子直线加速器,6mV-X线,Brain LAB公司三维治疗计划系统行三维适形放疗(3D CRT)。3～5Gy/次,5次/周。照射剂量研究组55～60Gy、对照组65～70Gy。采用SCT和MRI比较两组近期疗效,并比较两组不良反应。结果研究组近期有效率(CR+PR)80%,对照组55%。两组不良反应发生率中白细胞下降,口咽黏膜急性放射反应,放射性皮肤反应症状分别为10%(4/40),8%(3/40),5%(2/40)和15%(6/40),13%(5/40),15%(6/40)(P<0.05)。结论福莫斯汀可增加局部复发老年鼻咽癌的放射敏感性,表现为在降低放疗剂量的情况下,提高了复发老年鼻咽癌的近期疗效且不增加不良反应。
Objective To observe the radiosensitization effect of formostatin combined with three-dimensional conformal radiotherapy (3D CRT) on locally advanced nasopharyngeal carcinoma. Methods Eighty patients with relapse were the first clinical symptom of worsening of epistaxis, nasal congestion, headache, tinnitus and hearing loss after the first course of radiotherapy. The clinical symptoms of nasal bleeding, nasal congestion, headache, tinnitus and hearing loss appeared after a period of time (> 6 months) , Diagnosed as recurrence by pathology, were randomly divided into study group and control group, 40 cases in each group. The study group Formositine 208mg / m2 with 4ml ampoules dissolved in sterile ethanol solution, and then added to 250ml 5% isotonic glucose diluted intravenous infusion 60min after the end of the input radiotherapy and radiotherapy were Siemens linear accelerator , 6mV-X line, Brain LAB 3D treatment planning system three-dimensional conformal radiotherapy (3D CRT). 3 ~ 5Gy / time, 5 times / week. The irradiation dose was 55-60 Gy in the study group and 65-70 Gy in the control group. Short-term curative effect was compared between the two groups by SCT and MRI, and two groups of adverse reactions were compared. Results The study group was recently effective (CR + PR) 80%, control group 55%. The incidences of leukopenia, acute oropharyngeal mucosal radiation, and radioactive skin reactions were 10% (4/40), 8% (3/40), 5% (2/40) and 15% 6/40), 13% (5/40), 15% (6/40) (P <0.05). Conclusion Formustine can increase the radiosensitivity of locally advanced nasopharyngeal carcinoma in elderly patients. The results show that in the case of lower radiotherapy dose, it improves the short-term efficacy of recurrence of elderly nasopharyngeal carcinoma without increasing adverse reactions.