Fischer M, Pöttgen C, Wechsler S, Stuschke M, Jahnke K
Universitäts-Hals-Nasen-Ohren-Klinik, Universität Duisburg-Essen, Hufelandstrasse 55, 45122 Essen.
HNO. 2007 Dec;55(12):950-5. doi: 10.1007/s00106-007-1542-8.
The excellent results yielded by hyperfractionated and accelerated radiotherapy associated with concurrent chemotherapy in locally advanced oropharyngeal and hypopharyngeal carcinomas led to investigation of this therapeutic regimen in nasopharyngeal carcinomas also.
Thirty-five patients with stage III and IV nasopharyngeal carcinomas received accelerated hyperfractionated radiotherapy with concurrent chemotherapy (5-FU, mitomycin C + leucovorin). In the first 3 weeks of treatment five 2-Gy doses per week were delivered to the primary tumour and regional lymph nodes. The fractionation was then accelerated, with 1.4 Gy given twice daily until a total dose of 72 Gy had been administered.
The overall objective response rate was 100%. The median follow-up period was 71 months. Salvage surgery of the lymph nodes was performed in 10 patients, revealing vital tumour tissue in 6 of these. The actuarial 5-year local control rate was 64% (95%CI: 47-81%), while overall actuarial survival at 5 years was 70% (95%CI: 53-86%).
Hyperfractionated accelerated radiotherapy with concurrent chemotherapy is effective and feasible in locally advanced nasopharyngeal carcinoma.
超分割加速放疗联合同步化疗在局部晚期口咽癌和下咽癌中取得了优异的疗效，这也促使人们对该治疗方案在鼻咽癌中的应用进行研究。
35例III期和IV期鼻咽癌患者接受了加速超分割放疗联合同步化疗（5-氟尿嘧啶、丝裂霉素C+亚叶酸钙）。在治疗的前3周，每周对原发肿瘤和区域淋巴结给予5次2Gy剂量的照射。然后加快分割，每天给予2次1.4Gy照射，直至总剂量达到72Gy。
总体客观缓解率为100%。中位随访期为71个月。10例患者进行了淋巴结挽救性手术，其中6例发现有存活的肿瘤组织。5年精算局部控制率为64%（95%CI：47-81%），5年总体精算生存率为70%（95%CI：53-86%）。
超分割加速放疗联合同步化疗在局部晚期鼻咽癌中有效且可行。
