诱导性动脉内灌注化学治疗在晚期鼻咽癌治疗中的价值

目的：明确诱导性区域动脉灌注化学治疗在局部晚期鼻咽癌（nasopharyngeal carcinoma,NPC)治疗中的价值。方法：采用前瞻性随机对照研究，将病理确诊的121例晚期（Ⅲ-Ⅳ期）初治NPC患者于放射治疗前随机分面两组，61例进行区域性动脉灌注化学治疗（intra-arterial chemotherapy,IACT),60例采用全身化学治疗（systemic chemotherapy,SCT)，对比化学治疗完全缓解率及毒副反应发生情况，放射治疗后比例两组的疗效，统计学处理采用卡方检验。结果：IACT组化学治疗全身性毒副反应发生率较SCT组低，口腔炎的发生率较高（P值分别为＜0．05或＜0．005）。IACT组有6例因血管闭塞不能进行第2疗程的化学治疗。IACT组化学治疗安全缓解率及5年生存率分别为27．9％（17／61）和63．9％（39／61），而SCT组分别为11．7％（7／60）和45．0％（27／60），两组相比较均有统计学差异（P值均＜0．05），两组间无瘤生存率比较，差异无显著性（P＞0．05）。结论：以IACT行诱导化学治疗对Ⅲ-Ⅳ期局部晚期NPC更为合理。

Value of regional intra-arterial induction chemotherapy for locally advanced nasopharyngeal carcinoma]

OBJECTIVE: To define the value of regional intra-arterial induction chemotherapy for locally advanced nasopharyngeal carcinoma (NPC). METHODS: 121 locally advanced NPC(stage III-IV) patients confirmed by pathology were randomly divided into two groups before radiation, and the two groups were given two different methods of chemotherapy: regional intra-arterial chemotherapy (IACT) and systemic chemotherapy (SCT). After radiation the effect of two methods was compared. RESULTS: The complete response rates were 27.9% in the IACT and 11.7% in the SCT, and 5 years survival rates were 63.9% in the IACT and 45.0% in the SCT respectively. The differences of two groups were significant. CONCLUSION: IACT is more reasonable than SCT as induction chemotherapy for these locally advanced NPC.