Yan J H, Qin D X, Hu Y H, Cai W M, Xu G Z, Wu X L, Li S Y, Gu X Z
Dept. Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Int J Radiat Oncol Biol Phys. 1989 Jun;16(6):1465-9. doi: 10.1016/0360-3016(89)90950-4.
One hundred and eighty-two nasopharyngeal carcinoma (NPC) patients, treated from March 1958 through 1978, received 70 Gy or more and were left with gross residual lesion in the nasopharynx, were retrospectively analyzed. Ninety-two patients were given a boost by reduced portals to a total of 90-120 Gy (boost group) whereas for the other non-randomized 90 patients, the treatment was stopped at 70 Gy (observation group). The local recurrence, distant metastasis and 5-year survival rates of the two groups are: 35% (32/92) vs. 58% (52/90), 20% (18/92) vs. 43% (39/90), and 54% (50/92) vs. 21% (19/90), respectively. The benefit of boost is more apparent in patients with T1-2 than T3-4 lesions (p less than 0.001), at increased risk of radiation encephalo-myelitis from 5.5% to 17%. The authors believe that boost be given to patients with early Stage T or small residual lesion at the primary site of NPC.
对1958年3月至1978年期间接受治疗的182例鼻咽癌患者进行回顾性分析，这些患者接受了70 Gy或更高剂量的放疗，且鼻咽部留有肉眼可见的残留病灶。92例患者通过缩小照射野追加剂量至90 - 120 Gy（追加剂量组），而另外90例未随机分组的患者在70 Gy时停止治疗（观察组）。两组的局部复发率、远处转移率和5年生存率分别为：35%（32/92）对58%（52/90），20%（18/92）对43%（39/90），以及54%（50/92）对21%（19/90）。追加剂量对T1 - 2期病变患者的益处比对T3 - 4期病变患者更明显（p小于0.001），放射性脑脊髓炎的风险从5.5%增加到17%。作者认为，应对早期T期或鼻咽癌原发部位残留病灶较小的患者追加剂量。
