Cummings B J, Blend R, Keane T, Fitzpatrick P, Beale F, Clark R, Garrett P, Harwood A, Payne D, Rider W
Laryngoscope. 1984 Dec;94(12 Pt 1):1599-605.
Evidence is presented of the effectiveness and relative lack of serious toxicity of external beam megavoltage radiation therapy (RT) as primary treatment for juvenile nasopharyngeal angiofibroma. The importance of careful radiological evaluation of tumor extent prior to irradiation is stressed, and only moderate dose RT is required. Fifty-five patients have been treated by RT and followed for from 3 to 26 years. Forty-four of 55 patients (80%) had permanent tumor control following a single course of 3000 cGy to 3500 cGy over 3 weeks. Surgical resection or a second course of RT controlled the tumor in all 11 patients in whom regrowth occurred. Angiofibromas involute slowly after RT so that 50% of patients still had visible masses in the nasopharynx 12 months after treatment, but only 10% had any visible abnormality 36 months after RT. Retreatment was necessary only if symptoms recurred, and continued follow-up showed that most asymptomatic nasopharyngeal masses resolved completely. Acute and late toxicity rates were low. Two patients developed tumors in the head or neck following RT. There was no significant clinical impairment of growth or endocrine function. A single course of external beam megavoltage radiation to 3000 cGy in 3 weeks is an effective first treatment for patients with juvenile nasopharyngeal angiofibroma.
有证据表明，外照射兆伏级放射治疗（RT）作为青少年鼻咽血管纤维瘤的主要治疗方法具有有效性且相对缺乏严重毒性。强调了在放疗前对肿瘤范围进行仔细放射学评估的重要性，并且仅需要中等剂量的放疗。55例患者接受了放疗，并随访了3至26年。55例患者中有44例（80%）在3周内接受3000 cGy至3500 cGy的单一疗程放疗后实现了永久性肿瘤控制。手术切除或第二疗程放疗控制了所有11例肿瘤复发患者的肿瘤。放疗后血管纤维瘤缓慢消退，因此50%的患者在治疗后12个月鼻咽部仍有可见肿块，但放疗后36个月只有10%的患者有任何可见异常。仅在症状复发时才需要再次治疗，持续随访显示大多数无症状的鼻咽部肿块完全消退。急性和晚期毒性发生率较低。2例患者放疗后在头颈部发生肿瘤。生长或内分泌功能没有明显的临床损害。在3周内对外照射兆伏级放射进行单一疗程至3000 cGy是青少年鼻咽血管纤维瘤患者有效的首次治疗方法。
