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目的比较鼻咽癌茎突后间隙侵犯调强放疗与常规放疗对预后的影响。方法将78例鼻咽癌患者分为常规放疗组40例和调强适形放疗组38例,常规放疗采用面颈联合野,两侧成角耳前野,耳后野,总剂量DT 70～74 Gy,调强放疗采用7个野照射,大体肿瘤GTV 69～73 Gy,对3年局控率﹑生存率﹑无远处转移生存率进行分析评价。结果所有患者随访均达到3年,常规放疗组3年局控率、生存率﹑无远处转移生存率分别为57.5%(23/40)、60.0%(24/40)、55.0%(22/40),调强放疗组3年局控率﹑生存率﹑无远处转移生存率81.6%(31/38)、78.9%(30/38)、68.4%(26/38),两者局控率比较,差异有统计学意义(P=0.0213)。结论调强适形放疗能够提高鼻咽癌茎突后间隙侵犯患者的局控率,改善生存率,远处转移是治疗失败的主要原因。
Objective To compare the prognosis of patients with nasopharyngeal carcinoma after styloid process invasion by intensity modulated radiotherapy and conventional radiotherapy. Methods 78 patients with nasopharyngeal carcinoma were divided into conventional radiotherapy group (n = 40) and intensity modulated conformal radiotherapy group (n = 38). Conventional radiotherapy was performed with facial and neck joint field. Gy, intensity modulated radiotherapy using 7 field irradiation, gross tumor GTV 69 ~ 73 Gy, 3-year local control rate ﹑ survival ﹑ no distant metastasis survival rate analysis and evaluation. Results All patients were followed up for 3 years. The 3-year local control rate, survival rate and distant metastasis-free survival rate in conventional radiotherapy group were 57.5% (23/40), 60.0% (24/40) and 55.0% (22 / 40). The 3-year local control rate, survival rate, distant metastasis-free survival rate were 81.6% (31/38), 78.9% (30/38), 68.4% (26/38) Rates, the difference was statistically significant (P = 0.0213). Conclusion Intensity-modulated conformal radiotherapy can improve the control rate of patients with nasopharyngeal carcinoma after the styloid process and improve the survival rate, distant metastasis is the main reason for treatment failure.