A Comparative Study About Efficacy And Side-effects Of Nasopharyngeal Carcinoma Patients By IMRT And CRT

Objetive:A comparative study about nasopharyngeal carcinoma patients who treated with IMRT or CRT,compare the difference about the two methods in efficiency rate,one-year,two-year,three-year overall survival rate,progression free survival rate,locoregional-control rate and radiotherapy side-effects. Compare the difference between two methods:If IMRT can improve efficiency rate and survival rate,reduce the radiotherapy side-effects.Methods:Collecte randomly 60 patients who initially- diagnosed nasopharyngeal carcinoma from January 2005 to January 2007,these patients hanve excluded distant metastasis,and treated with IMRT.Selecte randomly 60 nasopharyngeal carcinoma cases matched according to"92 TNM staging"who treated with CRT. The two groups have no differences in age,gender and staging .Compare the efficacy and radiotherapy side-effects between the two groups.IMRT patients were given the same amount synchronizely.The target volume is given prescription dose.GTVnx,T1-T2 69.9Gy,30times,2.33Gy per time;T3-T4 73.9Gy,32times,2.31Gy per time.GTVnd,CTV1,CTV2 is 66Gy, 60Gy, 54Gy respectively, all 30 times. Positive lymph node dose added to 70Gy if residue after review. CRT group is treated with two sides of large surface face-neck-joint field,plus two sides of the small surface face-neck-joint field, electronic beam is added on the lower-neck-side field.And using conventional segmentation and conventional dose,2Gy per time,five times per week. The first step irradiating left-right field an lower-neck-front field,DT36Gy;the second step avoid spinal cord , DT 50Gy ; the third step avoid brainstem,DT 66Gy;the fourth step arrive at radical dose. The nasopharynx dose is 70-76Gy, positive lymph node dose is 66Gy, added to 70Gy if residue after review.The stageâ…¢,â…£a patients in the two groups is recerved chemotherapy at the same time during radiotherapy. According to NCCN,chemotherapy regimen is :cisplatin 40mg/m~2,one time per week.Results:(1)Review respectively immediately after radiotherapy and three months after radiotherapy,the IMRT group is significantly better than CRT in CR rate and efficiency rate(P<0.05);(2)The two groups have no differences in one-year,two-year,three-yearOS,PFS and locoregional-control rate(P>0.05);(3)The radiotherapy side-effects such as acute skin reactions, dry mouth, mouth limited of IMRT group is significantly lower than the CRT group(P <0.05).Conclusions: (1)Compared with CRT,IMRT can improve the CR rate and efficiency rate of nasopharyngeal carcinoma patients;(2)Compared with CRT, IMRT can not improve the one-year,two-year,three-year OS,PFS and locoregional-control rate;(3) Compared with CRT, IMRT can reduce the radiotherapy side-effects such as acute skin reactions, dry mouth, mouth opening restriction, IMRT can improve patients quality of life.