晚期鼻咽癌放疗联合辅助性化疗的临床研究

目的 分析评价晚期（N2,N3期）鼻咽癌放疗加辅助化疗的疗效.方法 86例N2,N3期鼻咽癌患者随机分为放化组（A组,46例）和单放组（B组,40例）,均首先接受根治性放疗,其后放化组46例接受辅助化疗（LV＋5Fu＋DDP）3～4个疗程.结果 放化组5年生存率43.5%,单放组37.5%（P＞0.05）;放化组远处转移发生率19.6%,单放组45%（P＜0.05）;放化组远处转移发生时间平均放疗后18.3个月,单放组7.8个月;放疗后达到CR的放化组与单放组的5年生存率为42.9%、56.5%（P＞0.05）,非CR的放化组与单放组的5年生存率为44.4%、11.8%（P＜0.05）.结论 放疗加辅助性化疗N2,N3期鼻咽癌有助于延缓远处转移发生时间,减少远处转移;对于根治性放疗后未达CR者,辅助化疗能提高生存率.

The clinical study of adjuvant chemotherapy for advanced nasopharyngeal carcinoma

Objective To analyse the effect of adjuvant chemotherapy combined radiotherapy of advanced nasopharyngeal carcinoma(N2,N3 stage).Methods Eighty-six cases with N2,N3 stage nasopharyngeal carcinoma were randomized into two groups:chemoradiotherapy(A,46 cases) and radiotherapy alone(B,40 cases).The two groups received radiotherapy,then group chemoradiotherapy received adjuvant chemotherapy.Results The 5-year survival rate in group A was 43.5% and 37.5% in group B(P>0.05);The distant metastasis rates was 19.6% in group A and 41.7% in group B(P<0.05).The average time after radiotherapy of occurrence of distant metastasis was 18.3 months in group A and 7.8 months in group B.There was significant difference in 5-year survival rate between the 2 subgroups in patients who didn't reach CR(complete remission) after radiotherapy.Conclusions Radiotherapy combined with adjuvant chemotherapy may prolong the time of distant metastasis and may lower the distant metastasis for N2,N3 advanced stage NPC.Adjuvant chemotherapy is obviously beneficial to 5-year survival rate in patients who don't reach CR after radiotherapy.