摘要
目的探讨鼻咽癌常规分割放疗中等效生物剂量及总疗程时间对局控和生存的影响。材料与方法１５７例病理确认并进行ＣＴ检查的鼻咽癌于１９９２年３月至１９９４年４月完成常规分割根治性放疗，每次鼻咽中心剂量１．７１～１．９９Ｇｙ（中位每天每次１．８５Ｇｙ），总剂量６２．３～８４．０３Ｇｙ，照射３３～４５次／４８～７９天（中位７２．３Ｇｙ，３９次／５７天）。用总疗程时间及潜在倍增时间Ｔｐｏｔ（Ｔｐｏｔ＝４．０天）校正等效生物剂量，在分析总疗程时间的作用时，选择校正前等效生物剂量（Ｂｉｏｌｏｇｉｃａｌｅｆｅｃｔｉｖｅｄｏｓｅ，ＢＥＤ）在７９～９１Ｇｙ内的１２８例进行分析。应用Ｃｏｘ模型分析年龄、性别、Ｔ分期、Ｎ分期、等效生物剂量及总疗程时间对局控和生存率的影响。结果本组病例的３年生存率为６５．８％，３年无瘤生存率５６．６％，３年局控率７４．８％。影响生存和局控率的因素为Ｔ分期、等效生物剂量和总疗程时间。等效生物剂量＜４９Ｇｙ与≥４９Ｇｙ的３年生存率和局控率分别为３４．３％、５４．４％（Ｐ＝０．００１）和６９．７％、７７．１％（Ｐ＝０．００９）。校正前ＢＥＤ在７９～９１Ｇｙ范围内的１２８例患者中总疗程时间≤５６天与＞５６天的３?
Purpose To evaluate effect of the biological effective dose(BED) and overall treatment time on the actuarial survival(ASR) and the free from local failure(FLF) incidence of nasopharyngeal carcinoma treated with conventional radiotherapy.Materials and Methods From Mar. 1992 to Apr. 1994,157 new pathologically proven NPC cases were treated with conventional radical radiotherapy.The dose was 1.71～1.99Gy per fraction(median 1.85Gy per fraction), and the total dose was 62.3～84.03Gy/33～45f in 48～79 days(median 72.3Gy/39f in 57days). Overall treatment time and Tpot(Tpot=4.0) were used to calculate the BED.The effect of overall treatment time on ASR and FLF of 128 patients who received 65～75Gy was evaluated.Potentially significant parameters(age,sex,T stage,N stage,BED and overall treatment time) were analyzed by univariate and multivariate methods for each of the two clinical endpoints:ASR and FLF.Results The 3year ASR,FLF were 65.8%,74.8% respectively.The prognostic factors for the poorer ASR and FLF were: advanced T stage,lower BED and longer overall treatment time.The 3year ASR,FLF were higher (69.7%,77.1%)(P=0.009) in those patients with BED ≥ 49Gy than those with BED<49Gy (34.3%,54.4%)(P=0.001).The 3year ASR,FLF for the overall treatment time≤56 days and >56 days were 74.3%,83.8%(P=0.005) and 56.7%,61.9% respectively(P=0.005).Conclusion The lower BED and the longer overall treatment time are the independent prognostic factors for the poor ASR and FLF.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
1998年第1期41-45,共5页
Chinese Journal of Radiation Oncology
