顺铂放射增强效果在鼻咽癌病人中的临床观察

顺铂作为一种广谱抗肿瘤药物，它具有放射增强作用，尤其对于头颈部肿瘤中疗效明显提高，并且不增加急性反应，病人能耐受。本文采用前瞻性随机研究，对已确诊为鼻咽癌并有颈部淋巴结转移的７９例病人随机分为单纯放射组（Ⅰ组）和放射联合顺铂组（Ⅱ组）。放射治疗均采用同中心摆位，总量７０Ｇｙ／３５～３７次／７～８周。顺铂自放射开始后使用，１次／周，２０ｍｇ／ｍ２／次，共７～８次。分别以颈部转移性淋巴结缩小５０％和颈部皮肤干性脱皮来评价肿瘤组织放射效应及早期放射反应，结果获得治疗增益比提高１４％。急性反应主要是恶心、呕吐、口腔炎及干、湿性脱皮，但所有病人均能耐受而完成治疗。

Prospective Randomized Trial of Radiotherapy Plus Cisplatin(DDP)for Nasopharyngeal Carcionoma

Ninety eight patients with nasopharyngeal carcinoma were randomized into radiotherapy alone group (Arml.48 cases)and radiotherapy plus DDPgroup(Arm2.50 cases).Radiotherapy was demonstrated isocentrally for all patients,and the total dose of 70Gy/35 37 fractions /7 8 weeks.Cisplatin was given with 20mg/m 2 once week for 7 8 weeks.The results showed that patients in Arm2 had higher CR rate than in Arml.Followed up for three years (median 40 months),the three year survival rate was 76% in Arml and 83% in Arm2.The acute and late reaction were more severe in Arm2 than that in Arml,but all were tolerable.