放疗加诱导化疗治疗晚期鼻咽癌的临床观察

 目的　评价诱导化疗对晚期鼻咽癌放疗疗效的影响。方法　 1 993年 2月至 1 995年 1 2月 ,1 1 8例 、 期鼻咽癌患者随机分为两组 (化放组及单放组 ) ,每组 59例。放疗采用60 Co机或直线加速器照射。鼻咽癌原发灶 DT66～ 76Gy/6.5～ 7.5w,颈部 DT50～ 66Gy/5～ 6.5w。化疗组在放疗前采用 DDP+5- Fu方案诱导化疗。结果　 5年生存率化放组为 57.6% ,单放组为 35.6% ,差别有统计学意义 (P<0 .0 5)。化放组远处转移率为 2 8.9% ,单放组为 40 .7% ,差别有统计学意义 (P<0 .0 5)。结论　放疗加诱导化疗能提高晚期鼻咽癌的生存率并可降低远外转移率。

Clinical Observation of Radiotherapy plus Induction Chemotherapy in Advanced Nasopharyngeal Carcinoma

Objective To evaluate the influence of induction chemotherapy onradiotherapy in advanced nasopharyngeal carcinoma.Methods From February 1993 to December 1995,118 Patients with histologically proven nasopharyngeal carcinoma in Ⅲ、Ⅳ stage were divided randomly into two groups. Radiotherapy group(59 cases)was only treated by cobalt 60 or linear accelerator with DT 66～76 Gy in nasopharynx and DT50～66Gy in the neck.Chemoradiothdrapy therapy group (59 cases)received induction chemotherapy with cisplatin and 5～fluorouracil before radiotherapy received as radiotherapy group.Results The 5～year survival rates were 57.6% in chemoradiotherapy group and 35.6% in radiotherapy gnoup,respectively,with significant,difference between the two groups (P＜0.05).Distant metastasis rates were 28.9% in chemoradiotherapy group and 40.7% in radiotherapy group,respectively (P＜0.05).Conclusion Radiotherapy plus induction chemotherapy can increase the survival rates and decrease distant metastasis rates for advanced nasopharyngeal carcinoma.