摘要 比较外照射联合高剂量率后装腔内放疗与单纯外照射治疗的远期疗效及后遗症。对80例鼻咽癌(T_1～2 N_0～1 M₀ )首程外照射联合高剂量率后装腔内放疗(综合放疗组)，配对80例鼻咽癌(T_1～2 N_0～1 M₀ )同期接受单纯外照射治疗(单纯外照射组)。综合放疗组，外照射剂量为52～72Gy，腔内后装剂量为7～24Gy/1～4次，1～2周；单纯外照射组剂量为66～82Gy。结果：综合放疗组与单纯外照射组的鼻咽肿瘤完全消退率分别为98.8%和97.5%，差异无显著性(P>0.05)；鼻咽肿瘤局部控制率分别为95.0%和83.8%，差异有显著性(P<0.05)；5年生存率分别为81.3%和70.0%，差异无显著性(P>0.05)。张口困难发生率综合放疗组低于单纯外照射组(17.5%对33.8%，P<0.05)。综合放疗组未发现硬软腭穿孔、溃疡等。认为鼻咽癌外照射结合腔内高剂量率后装治疗，能提高肿瘤局部控制率，减少并发症的发生，而其生存率似有所提高，但差异无显著性。

Yang Wen Yang Xiangxian Wu Hong Chen Hailin Lin Wen

Guangdong Agriculture Reclamation Hospital, Zhanjiang, Guangdong, P.R.China 524002

The efficacy and sequelae comparison of the combination of external irradiation with intracavitary brachytherapy of high dose rate to simple radiotherapy for nasopharygeal carcinoma (NPC) were evaluated. From May 1992 to September 1993, 80 NPC T_1-2 N_0-1 M₀ patients were treated with combined external irradiation plus intracavitary brachytherapy of high dose rate (combination radiotherapy group) and 80 NPC T_1-2 N_0-1 M₀ patients were treated with simple external beam therapy (simple radiotherapy group). In combination radiotherapy group, patients received external beam for 52～72Gy, brachytherapy for 7～24Gy/1～2w at the reference point. For simple radiotherapy group, patients received external beam only with the total dose of 66～82Gy. All patients were followed up for more than 5 years. Patients received combination radiotherapy group had a better local control rate than those of simple radiotherapy group (95.0 % VS 83.8%, P<0.05). The 5-year survival rates were 81.3% and 70.0% in combination radiotherapy group and simple radiotherapy group, respectively, (P>0.05). Patients received combination radiotherapy had a lower trismus than those of simple radiotherapy group (17.5% VS 33.8%, P<0.05). It could be concluded that external irradiation plus intracavitary brachytherapy can improve local control rate for naso-pharyngeal carcinoma. The 5-year survival rate seems better in combination radiotherapy group than in simple radiotherapy group, statistical difference was not observed. It may cause milder complication in combination radiotherapy group than in simple radiotherapy group.

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