Objective: To study the feasibility of submandibular gland protection technology in two-dimensional conformal radiotherapy for nasopharyngeal carcinoma and it' s effect on local control. Methods: From May 2002 to July 2004, 60 nasopharyngeal carcinoma patients with Nq stage or Nj stage (cervical lymph node <2cm) were treated by two-dimensional conformal radiotherapy through conventional fractionation or hyperfractionation. Submandibular gland was protected completely or partially depending on the size of cervical lymph node. Results: The 5-year overall survival (OS) rate, disease-free survival ( DFS) rate, local-regional control rate were 86. 4% ,81. 7% ,and 93. 2% ,respectively. No recurrence was observed in mandibular or submental area. Three cases had no xer-ostomia(5% ) . Mild, moderate, and severe xerostomia occurred in 39 (65%),17(28%),1(2%) cases, respectively. Conclusion: Protection technology of submandibular region can be used to alleviate the degree of xerostomia without affecting local-regional control rate for nasopharyngeal carcinoma patients with Nq or partial Nj stage.%目的:探索鼻咽癌二维适形照射中对下颌下腺进行保护的可行性及对局部控制率的影响.方法:2002年5月~2004年7月,对60例N0及颈部淋巴结＜2cm的N1期鼻咽癌患者,用面膜固定,个体化二维适形常规或超分割方式照射,根据颈淋巴结大小进行下颌下腺部分或全部保护.结果:60例鼻咽癌患者全组5年生存率86.4%,5年无病生存率81.7%,5年局部控制率93.2%,无下颌区或颏下区肿瘤复发.口干程度有所减轻,无口干症状(G1)3例(5%);轻度口干(G2)39例(65%);中度口干(G3)17例(28%);重度口干(G4)1例(2%).结论:N0及部分N1期鼻咽癌患者可对下颌下腺区域进行保护,避免照射,可减轻口干程度而不影响局部控制率.
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