摘要
目的观察顺铂(DDP)联合三维适形放疗(3DCRT)对局部复发上颌窦癌的放射增敏作用。方法66例复发者均为首程放疗后达其本痊愈或明显好转,一段时间(>8个月)后又出现鼻涕、鼻塞、疼痛、面部肿胀等情况恶化的临床症状,经病理检查确诊为复发,随机分为研究组和对照组,每组33例。研究组DDP20mg/m2用生理盐水250ml稀释后静脉滴注,滴注结束后50min内放疗,放疗均采用西门子直线加速器,6mV-X线,BrainLAB公司三维治疗计划系统行三维适形放疗(3DCRT)。3～5Gy/次,4～5次/周。照射剂量研究组45～50Gy、对照组55～60Gy。采用SCT和MRI比较两组近期疗效,并比较两组不良反应差别。结果研究组近期有效率(CR+PR)为73%,对照组为42%。两组不良反应发生率中白细胞下降,Ⅲ度以上口腔黏膜反应,脑水肿症状分别为24%(8/33)、3%(1/33)、24%(8/33)、和21%(7/33)、18%(6/33)、18%(6/33)(P<0.05)。结论DDP可增加局部复发上颌窦癌的放射敏感性,表现为在降低放疗剂量的情况下,提高了复发上颌窦癌的近期疗效且不增加不良反应。
Objective To investigate the radiosensitive effect of three dimensional conformal radiotheraphy and cisplatin （DDP） against locally recurrent maxinary sinus carcinoma. Methods All sixty - six recurrences basically recoverd or turned for the better after the 1st radiotherapy. After a period of time （ 〉 8 months）, these patients had the deterioration symptoms ： nasal mucus, snuffle, pain, facial swelling and so on, and they were diagnosised as the recurrence after the pathological examination. Then, these 66 patients were randomly divided into the study group（33 patients） and control group（ also 33 patients ）. The patients in study group were treated with the intravenous infusion of DDP 20mg/mEdilated 250ml sodium chloride and radiotherapies were given within 50 min after each infusion. All patients received three dimensional conformal radiotheraphy（3DCRT） at 3 - 5Gy per fraction, 4 -5 fraction a week to a total dose of 45 -55 Gy in study group and 55 -60Gy in control group. The short -term therapeutic effect and side effects were compared between the two groups with SCT and MRI. Results The short - term effective rates（ CR ＋ DR） were 73% in the study group and 42% in the control group （P 〈 0. 05 ）. There were no significant difference in the side effects between the two groups （P 〉 0. 05 ）. Conclusion DDP may enhance the radiosensitivity of locally recurrent maxinary sinus carcinoma. 3DCRT combined with cisplatin may improve the short -term effect rate,reduce the radiotheraphy dose and does not increase the side effects.
出处
《医药论坛杂志》
2009年第8期9-11,共3页
Journal of Medical Forum
关键词
三维适形放疗
复发上颌窦癌
顺铂
Tree dimensional conformal radiotheraphy
Cisplatin
Maxinary sinus carcinoma
