Fischer M, Stüben G, Klahold M, Stuschke M, Budach V, Sack H, Jahnke K
Department of Otorhinolaryngology, University of Essen, Germany.
J Cancer Res Clin Oncol. 2001 Aug;127(8):507-11. doi: 10.1007/s004320100242.
The incidence of nasopharyngeal carcinoma in Germany is relatively low in comparison with certain regions in south-east Asia. However, standardised therapeutical regimes are required in the treatment of these tumours.
Between August 1990 and December 1997, 25 patients with stage III and IV nasopharyngeal carcinoma received an accelerated and hyperfractionated radiotherapy with concurrent chemotherapy (5-FU and mitomycin C). The primary tumour and positive lymph nodes received a total dose of 72 Gy over a period of 6 weeks. In the first 3 weeks, irradiation fields were treated five times per week with 2 Gy per fraction. Thereafter, treatment was accelerated, giving two daily fractions of 1.4 Gy. Salvage surgery was offered for residual lymph node disease after radiotherapy.
The overall response rate defined as complete and partial response of the primary was 100%. Sixteen of the 25 patients were still alive and were free of any evidence of tumour recurrence or distant metastases at a mean follow-up period of 34 months (range 7-95 months). Six patients received salvage surgery. Only one of these six patients had histologically proven evidence of vital tumour. No severe late complications such as blindness or temporal lobe necrosis were observed.
The presented data are promising and show that the combination of hyperfractionated accelerated radiotherapy and chemotherapy is feasible and effective.
与东南亚某些地区相比，德国鼻咽癌的发病率相对较低。然而，这些肿瘤的治疗需要标准化的治疗方案。
1990年8月至1997年12月期间，25例III期和IV期鼻咽癌患者接受了加速超分割放疗并同步化疗（5-氟尿嘧啶和丝裂霉素C）。原发肿瘤和阳性淋巴结在6周内接受了72 Gy的总剂量照射。在最初的3周内，照射野每周治疗5次，每次分割剂量为2 Gy。此后，治疗加速，每天给予两个1.4 Gy的分割剂量。放疗后对残留淋巴结疾病提供挽救性手术。
以原发灶的完全缓解和部分缓解定义的总缓解率为100%。25例患者中有16例仍存活，在平均34个月（范围7 - 95个月）的随访期内无任何肿瘤复发或远处转移的证据。6例患者接受了挽救性手术。这6例患者中只有1例经组织学证实有存活肿瘤。未观察到严重的晚期并发症，如失明或颞叶坏死。
所呈现的数据很有前景，表明超分割加速放疗和化疗相结合是可行且有效的。
