紫杉醇同步后程三维适形放疗治疗局部晚期鼻咽癌的临床观察

目的：探讨每周一次紫杉醇同步后程三维适形放射治疗局部晚期鼻咽癌的临床疗效。方法：96例局部晚期鼻咽癌患者随机分为化放组51例和单放组45例。两组鼻咽部均采用常规放疗36Gy后行三维适形放疗,总照射剂量为72-76Gy,颈部常规放疗,预防剂量50-60 Gy,治疗剂量60-70Gy。化放组同步行紫杉醇化疗,60mg/次,静脉滴注,第1、8、15、22、29、36天。结果：化放组CR为84.3%,单放组CR为66.6%,（P〈0.05）;两组1年、2年、3年生存率分别为92.2%、86.3%、78.4%和82.2%、73.3%、57.8%;其中3年生存率差异具有统计学意义（P〈0.05）。化放组骨髓抑制及口腔反应较单放组增加,但经处理后均能顺利完成治疗。结论：每周一次紫杉醇同步后程三维适形放疗治疗局部晚期鼻咽癌具有较好的疗效,不良反应能耐受,值得临床进一步研究及应用。

Effect of paclitaxel weekly with late course three dimensional conformal radiotherapy on locally advanced nasopharyngeal carcinoma

Objective：To investigate the clinical effects of paclitaxel weekly with late course three dimensional conformal radiotherapy in locally advanced nasopharyngeal carcinoma.Methods： A total of 96 patients with locally advanced nasopharyngeal carcinoma were randomly divided into chemoradiotherapy group（C＋R group,n=51） and radiotherapy group（R group,n=45）.All patients were treated first with conventional radiotherapy and then three dimensional conformal radiotherapy,in and total dose of 72-76Gy at nasopharynx;and the patients in chemoradiotherapy group were also given chemotherapeutic regimen including 60mg of paclitaxel weekly.Results： The CR was 84.3% in chemoradiotherapy group and 66.6% in the radiotherapy group（P0.05）.The 1,2,3-year survival rates were 92.2%,86.3%,78.4% and 82.2%,73.3%,57.8% respectively in the two groups,there was significant difference between the two groups in 3-year survival rate（P0.05）.The rates of hematological toxicity and reactions of oral mucosa were higher in chemoradiotherapy group than in radiotherapy group,but all therapy plans were finished completely.Conclusion： Paclitaxel weekly combined with late course three dimensional conformal radiotherapy may improve the effective rate of nasopharyngeal carcinoma,and the side effects were tolerated.