同步放化疗在中晚期鼻咽癌的疗效分析

目的中晚期鼻咽癌局部复发和远处转移率较高,采用单纯放疗其疗效不甚理想。有研究报道同期放化疗能提高中晚期鼻咽癌患者的疗效,本研究着重探讨放疗同期化疗治疗中晚期鼻咽癌的疗效。方法将60例Ⅲ、ⅣA期鼻咽癌患者随机分为放疗同期化疗组（研究组）及单纯放疗组（对照组）每组各30例,研究组于放疗第1周开始,使用FD方案,顺铂20mg/m2,加入250ml0.9%氯化钠注射液,静脉滴注,第1～4天;氟尿嘧啶600mg/m2,加入500ml0.9%氯化钠注射液,静脉滴注,第1～5天。21d/次,连用6次。放疗采用常规分割放疗,2GY/次/d,5次/周。病灶区剂量70GY/35次,颈部淋巴引流区给予预防剂量56GY/28次或治疗剂量70GY/35次。对照组单纯放疗,方法同研究组放疗。结果研究组与对照组相比明显提高了Ⅲ、ⅣA期鼻咽癌患者的颈部淋巴结完全缓解率以及1、3、5年生存率和无瘤生存率;显著降低了远处转移发生率,两组相比差异有统计学意义。结论同期放化疗较单纯放疗提高了中晚期鼻咽癌的颈部淋巴结完全缓解率以及1、3、5年生存率和无瘤生存率,显著降低了远处转移的发生率。

Efficacy of Concurrent Chemoradiation in Middle-Advanced Nasopharyngeal Carcinoma

Objective Middle-advanced nasopharyngeal carcinoma hhs higher local recurrence and distal metastasis, radiotherapy alone failed to produce favorable response. Studies revealed that eoneurrent chemoradi- ation could bring about much higher response, based on this theory, we, in this study, mainly focus on detecting the efficacy of concurrent chemoradiation in middle-advanced nasopharyngeal carcinoma. Methods 60 cases with stage In ,1VA were randomly divided into concurrent group （30 cases） and radiotherapy alone group （30 cases）, at the first day of radiotherapy, chemotherapy started, the regimen was FD（ DDP 20 mg/m2, with 250 ml N. S ivgtt, dayl - 4 ; 5-FU600 mg/m2, with 500 ml N. S, continuous infusion, dayl -5, repeated every 21 days, 6 cycles. We used standard fractionated radiation, 2GY/d, 5 d/w. 70GY in primary tumor site. Same method was given in radiotherapy alone group. Results Compared with control group, chemoradiation group significantly increased the response rate of involved lymph nodes around neck, also increased 1-year, 3-year and 5-year survival rate, as well as disease free time; meanwhile, significantly decreased the distal metastasis rate. Significant difference lied when compared. Conclusion Compared with control group, chemoradiation group significantly increased the re- sponse rate of involved lymph nodes around neck, also increased 1-year, 3-year and 5-year survival rate, as well as disease free time; meanwhile, significantly decreased the distal metastasis rate.