中山大学肿瘤防治中心鼻咽癌诊治技术获重要进展

2012-07-09 驻地记者徐平鸽 通讯员陈鋆 医学论坛网

  鼻咽癌是我国头颈部常见恶性肿瘤之一,近20年来,由于影像诊断与放射治疗技术的进步使鼻咽癌的诊治水平产生了质的飞跃,鼻咽癌病人的生存率得以提高。   60年代以前:主要靠x射线,60年代以后:60co机治疗机,80年代:直线加速器,设备的落后医师只能以鼻咽顶后壁软组织的厚度和边缘的光滑度来判断是否鼻咽癌,随着影像诊断技术的进步,MRI 与CT的引进,使得对鼻咽癌的照射更加精准,准确定

  鼻咽癌是我国头颈部常见恶性肿瘤之一,近20年来,由于影像诊断与放射治疗技术的进步使鼻咽癌的诊治水平产生了质的飞跃,鼻咽癌病人的生存率得以提高。

  60年代以前:主要靠x射线,60年代以后:60co机治疗机,80年代:直线加速器,设备的落后医师只能以鼻咽顶后壁软组织的厚度和边缘的光滑度来判断是否鼻咽癌,随着影像诊断技术的进步,MRI 与CT的引进,使得对鼻咽癌的照射更加精准,准确定位靶向照射;提高对肿瘤的剂量;减少遗漏所致未控与复发;有效减少敏感器官照射体积与剂量;减低放射毒性;提高生存质量。卢泰祥教授及研究团队经过长期临床随访结果表明:IMRT对鼻咽癌有明显的疗效提高;IMRT应该成为鼻咽癌的首选治疗手段。

  卢泰祥教授领衔的研究团队经多年的潜心研究不断探索,并对868例鼻咽癌患者IMRT临床研究,男性677例,女性191例,男女比例3.5:1;年龄13—78岁,中位年龄43岁;分期:Ⅰ期51例、Ⅱ期215例、Ⅲ期412例、Ⅳa160例和Ⅳb30例。采用放疗加化疗,全组病例均接受孔雀系统断层步进根治性IMRT。T1-2N0-1患者主要采用单纯放疗,297例采用单纯放疗。T3-4或N2-3病例采用同期放化疗为主的综合治疗。41例采用诱导化疗或辅助化疗加放疗,530例采用以铂类为主的同期放化综合治疗。研究发现:N分级越高,远处转移风险越大;各N分级期间的差异较均匀,N分期增加一个级别,DMFS下降约10%。鼻咽癌患者生存率大幅提高,Ⅰ期到Ⅳ期的鼻咽癌无远处转移生存率达83.3%,居全国首位。



    

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