Chang J T, See L C, Liao C T, Chen L H, Leung W M, Chen S W, Chen W C
Department of Radiation Oncology, Chang-Gung Memorial Hospital, Taiwan.
Jpn J Clin Oncol. 1998 Mar;28(3):207-13. doi: 10.1093/jjco/28.3.207.
To evaluate radiotherapy dose and length of treatment in the control of early stage nasopharyngeal carcinoma (NPC) treated with a combination of external radiotherapy and brachytherapy,
MATERIALS & METHODS: We reviewed the records of 133 patients with early stage nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who received definitive radiotherapy in Chang Gung Memorial Hospital from 1979 to 1991. The median follow-up time was 7.1 years with a minimum of 2 years. All patients were treated with megavoltage external radiotherapy to the nasopharynx area (63-72 Gy) followed by high dose rate intracavitary brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4 Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used to examine the effect of several variables on prognosis.
The 5-year rates were 86.4% for local control, 84.7% for disease free survival, 88.5% for actuarial survival and 84.2% for overall survival. The treatment group (combination of time and dose of irradiation) was the most important prognostic factor according to Cox's proportional hazard model. Patients receiving radiation at a total dose of < or = 75 Gy completed in < 12 weeks showed the best prognosis.
Treatment time and total treatment dose are both important factors in treating early stage NPC. Decreasing the total radiation time to < 12 weeks and not exceeding a radiation dose of 75 Gy gave the best results.
评估外照射放疗与近距离放疗联合治疗早期鼻咽癌（NPC）时的放疗剂量及治疗时长。
我们回顾了1979年至1991年在长庚纪念医院接受根治性放疗的133例早期鼻咽癌患者（AJC/UICC分期系统中的I期或II期）的记录。中位随访时间为7.1年，最短为2年。所有患者均接受鼻咽部兆伏级外照射放疗（63 - 72 Gy），随后进行高剂量率腔内近距离放疗（分1至3次，每次5 - 16.5 Gy，间隔1 - 2周）。中位总剂量和照射时间分别为75 Gy（69.8 - 81.4 Gy）和11.6周（7.8 - 20周）。采用生存分析来检验几个变量对预后的影响。
5年局部控制率为86.4%，无病生存率为84.7%，精算生存率为88.5%，总生存率为84.2%。根据Cox比例风险模型，治疗组（照射时间和剂量的组合）是最重要的预后因素。总剂量≤75 Gy且在12周内完成放疗的患者预后最佳。
治疗时间和总治疗剂量都是治疗早期鼻咽癌的重要因素。将总放疗时间缩短至<12周且不超过75 Gy的放疗剂量可获得最佳效果。
