204例中晚期鼻咽癌同期放化疗与单纯放疗的远期疗效比较

目的：探讨同期放化疗对中晚期鼻咽癌患者的远期临床疗效.方法：选取204例中晚期鼻咽癌患者,分为同期放化疗组102例（研究组）和单纯放疗组102例（对照组）,每组再分低危和高危两个亚组,两组放疗方法相同.研究组于放疗前及放疗第4周给予DDP20 mg/m2,d1-3,5-FU 500 mg/m2,d1-3.结果：研究组和对照组5年总生存率（OS）分别为69.6％和51.0％,差异有统计学意义（P＜0.05）;5年无进展生存率（PFS）分别为60.8％和44.1％,差异有统计学意义（P＜0.05）;5年无复发生存率（RFS）分别为88.7％和73.1％,差异有统计学意义（P＜0.05）;5年无远处转移生存率（DMFS）分别为78.9％和71.2％,差异无统计学意义（P＞0.05）.低危亚组患者间的5年OS为80.7％和53.1％,差异有统计学意义（P＜0.05）、PFS为68.4％和45.3％,差异有统计学意义（P＜0.05）、RFS为95.3％和77.8％,差异有统计学意义（P＜0.05）、DMFS为83.7％和75.0％,差异有统计学意义（P＞0.05）.结论：同期放化疗可提高中晚期鼻咽癌患者的5年OS、PFS及RFS,但其5年DMFS无明显减少.

Comparision of the long-term curative effect of the concurrent chemoradiotherapy with the radiotherapy alone for 204 patients with middle or advanced-stage nasopharyngeal carcinoma

Objective. To investigate the long-term clinical effect of the concurrent chemoradiotherapy and the radiotherapy alone on patients with middle or advanced-stage nasopharyngeal carcinoma （NPC）. Methods. 204 NPC patients were divided equally into 2 groups. 102 patients in the experimental group were treated by concurrent chemoradiotherapy and the orther 102 patients in the con trol group by radiotherapy alone. Both groups were furtherly divided into 2 subgroups of low-risk and high-risk; Radiation therapy in both groups was the same. Patients in the experimental group were treated by DDP 20mg/m2, dl-3 and 5-FU 500mg/m2 , dl-3, 4 weeks before and after the radiotherapy. Results： The 5-year overall survival （OS） rate of the experimental group and the control group were 69.6% and 51.0K （P〈0.05） respectively; 5-year progression-free survival （PFS） rate of both groups were 60.8% and 44.1% （P〈0.05） respectively; 5-year recurrence-free survival （RFS） rate of both group were 88.7% and 73.1% （P〈0.05） respectively; 5-year distant metasta- sis-free survival （DMFS） rate of both groups were 78.9% and 71.2% （P〈0.05） respectively. The 5-year OS, PFS, RFS, DMFS of the low-risk subgroup in the experimental group and the control group were 80. 7% and 53. 1% （P〈0. 05）, 68.4% and 45.3% （P〈0. 05）, 95.3% and 77.8% （P d0.05）, 83.7% and 75.0K （P〈0. 05）, respectively. Conclusion. Concurrent chemoradiotherapy can increase the 5-year OS, PFS and RFS of middle or advanced-stage nasopharyngeal NPC, but 5- year DMFS has no significant decrease. In addition, the intensity of chemotherapy should be increased for patients in the high-risk subgroup.