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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Late course accelerated hyperfractionated radiotherapy of nasopharyngeal carcinoma (LCAF).
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Late course accelerated hyperfractionated radiotherapy of nasopharyngeal carcinoma (LCAF).

机译：鼻咽癌的晚期病程加速超分割放疗（LCAF）。

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BACKGROUND AND PURPOSE: To study the efficacy of late course accelerated fractionated (LCAF) radiotherapy in the treatment of nasopharyngeal carcinoma (NPC). The end-points were local control, radiation-induced complications, and factors influencing survival. PATIENTS AND METHODS: Between December 1995 and April 1998, 178 consecutive NPC patients were admitted for radiation treatment. The radiation beam used was (60)Co gamma or 6MV X rays. For the first two-thirds of the treatment, two daily fractions of 1.2Gy were given to the primary lesion, with an interval of 6h, 5days per week to a total dose of 48Gy/40 fractions, over a period of 4 weeks. For the last third of the treatment, i.e., beginning the 5th week of treatment, an accelerated hyperfractionated schedule was carried out. The dose per fraction was increased to 1.5Gy, 2 fractions per day with an interval of 6h, the total dose for this part of the protocol was 30Gy/20 fractions over 2 weeks. Thus the total dose was 78Gy in 60 fractions in 6 weeks. RESULTS: All patients completed the treatment. Acute mucositis: none in 2 cases, Grade 1 in 43 cases, Grade 2 in 78 cases, Grade 3 in 52 cases, and Grade 4 in 3 cases. Local control rate: the 5year nasopharyngeal local control rate was 87.7%, and the cervical lymph nodes local control rate was 85.7%. The 5-year distant metastasis rate was 26.1%, and 5year survivals were 67.9%, 16 (9%) patients had radiation-induced cranial nerve palsy, 7(4%) patients had temporal lobe or brainstem damage. CONCLUSIONS: With this treatment schedule, patients' tolerance was good, local control and 5year survivals were better than conventional fractionation schedules, and radiation-related late complications did not increase, as 5-year survival rates of conventional fractionation radiotherapy were only 58%. Randomized clinical trials are being carried out to further confirm the efficacy of LCAF for nasopharyngeal carcinoma.
机译：背景与目的：研究晚期加速分级（LCAF）放射治疗鼻咽癌（NPC）的疗效。终点是局部控制，辐射引起的并发症以及影响生存的因素。患者与方法：在1995年12月至1998年4月之间，连续178名NPC病人被接受放射治疗。使用的辐射束是（60）Coγ射线或6MV X射线。对于治疗的前三分之二，在4周的时间内，每天两次将1.2Gy的每日级分给予原发灶，间隔6小时，每周5天，总剂量为48Gy / 40级分。对于治疗的最后三分之一，即从治疗的第5周开始，进行了加速的超分割程序。每部分的剂量增加至1.5Gy，每天2次，间隔6h，该方案的这一部分的总剂量在2周内为30Gy / 20部分。因此，在6周内，总剂量为60组分的78Gy。结果：所有患者均完成治疗。急性粘膜炎：无2例，1级43例，2级78例，3级52例，4级3例。局部控制率：5年鼻咽局部控制率为87.7％，颈淋巴结局部控制率为85.7％。 5年远处转移率为26.1％，5年生存率为67.9％，其中16例（9％）患者发生了辐射诱发的颅神经麻痹，7例（4％）患者出现了颞叶或脑干损伤。结论：采用这种治疗方案，患者的耐受性良好，局部控制和5年生存率均优于常规分割方案，并且与放射有关的晚期并发症并未增加，因为常规分割放疗的5年生存率仅为58％。正在进行随机临床试验，以进一步证实LCAF对鼻咽癌的疗效。

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