同期放化疗治疗中晚期鼻咽癌临床研究

Radiotherapy with concurrent chemotherapy for treatment of advanced nasopharyngeal carcinoma]

OBJECTIVE: To evaluate the effect of radiotherapy combined with concurrent chemotherapy for the treatment of advanced nasopharyngeal carcinoma. METHODS: From February 2001 to August 2003, 80 cases of nasopharyngeal carcinoma (stage III and IVa) were randomized into two groups to receive radiotherapy with concurrent chemotherapy (Group A, n=40) consisted of leucovorin (CF, 100 mg/m(2), days 1-5), 5-fluorouracil (5-Fu, 500 mg/m(2), days 1-5), cisplatin (DDP, 60 mg/m(2), day 1) for one course followed by another 4 weeks later, or radiotherapy alone (Group B, n=40). In all cases, the radiotherapy followed the same protocol, with the nasopharyngeal (NP) total dose (DT) of 66-76 Gy given in 6.6-7.6 weeks, and cervical lymphnode (LN) DT of 60-72 Gy completed in 6.0-7.2 weeks. RESULTS: All patients completed the treatment course, and the complete response rates of the primary lesions and cervical nodes in A and B groups were 77.5% and 60.0% (P>0.05) and 92.5% vs 70.0% (P<0.05), respectively, which were 92.5% vs 72.5% (P<0.05) and 100% vs 85.0% (P<0.05), respectively, 3 months after treatment. No obvious toxicity was observed in the two groups except for vomiting and leukopenia. CONCLUSION: Radiotherapy with concurrent chemotherapy can improve the elimination rate of advanced nasopharyngeal carcinoma, and can be completed in shorter treatment course in comparison with neoadjuvant chemotherapy before radiotherapy, eligible for clinical practice in the treatment of advanced nasopharyngeal carcinoma.