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目的探究调强放疗(IMRT)治疗无远处转移下咽癌的临床疗效及放疗后对患者咽喉功能的影响。方法回顾性分析商丘市第一人民医院2010年6月至2012年6月收治的无远处转移下咽癌37例患者,其临床均采用IMRT治疗,原发灶肿瘤靶区(GTV)和颈部转移淋巴结(GTV2)放疗处方剂量均为66~70Gy。其中5例患者实施单纯放疗,32例患者实施放化疗,随访记录患者的疗效及其咽喉功能情况。结果 37例患者2年局部控制率、无病生存率、总生存率分别为70.27%、64.86%、59.46%,3例患者出现远处转移情况,有2例患者出现食管癌,生存时间超过2年患者中咽喉功能较好占90.91%,均表现有不同程度的放射黏膜反应和血液毒性。结论调强放疗(IMRT)应用于治疗无远处转移下咽癌患者,能有效提高其局部控制,且治疗后留咽喉功能情况保留较好,但局部复发率较高,易导致治疗失败。
Objective To investigate the clinical efficacy of IMRT in the treatment of pharyngeal carcinoma without distant metastasis and the effect of radiotherapy on the throat function of patients. Methods A retrospective analysis of 37 patients with distant metastasis of hypopharyngeal carcinoma admitted from June 2010 to June 2012 in Shangqiu First People’s Hospital was conducted. The patients were treated with IMRT, and the primary tumor target area (GTV) and neck Department of metastatic lymph nodes (GTV2) radiotherapy prescription dose are 66 ~ 70Gy. Among them, 5 patients were treated with radiotherapy alone, 32 patients received radiotherapy and chemotherapy, and the follow-up records of the patients and the throat function. Results The 37-year local control rate, disease-free survival rate and overall survival rate of 37 patients were 70.27%, 64.86% and 59.46% respectively. There were 3 patients with distant metastasis, 2 patients had esophageal cancer and the survival time exceeded 2 Throat function in patients with better 90.91%, all showed varying degrees of radiation mucosal reaction and hematotoxicity. Conclusions IMRT can be used to treat patients with hypopharyngeal carcinoma without distant metastasis, which can effectively improve the local control. After treatment, IMRT remains well, but the local recurrence rate is high, which may lead to the failure of treatment.