鼻咽癌综合治疗的临床研究

目的 :探讨一种适合对鼻咽癌进行综合治疗的方法。方法 :对 15 3例鼻咽癌随机分组研究 ;单纯放疗组 (甲组 )5 2例、放疗前诱导化疗组 (乙组 ) 5 2例、放疗同步化疗组 (丙组 ) 4 9例 ,各组均采用 6 0 Coγ射线或 4MVX线常规分割放疗 ,颈部加 180 KVX射线。鼻咽部剂量 70～ 80 Gy/ 7～ 8W,颈部预防照射 5 0 Gy/ 5 W,根治量 6 0～ 75 Gy/ 6～ 7.5 W。乙组在放疗前予 DDP5 0 m g,第 1,5天 ,5 - Fu5 0 0 mg,第 1～ 5天 ,静滴 ,休息 2周 ,再重复上述方案。丙组在放疗开始同时给予 DDP2 0 mg,第 1～ 5天 ,5 - Fu 5 0 0 m g,第 1～ 5天 ,静滴 ,第 4周再重复上述方案。结果 :甲、乙、丙组鼻咽部肿瘤完全消退率为 90 .4%、75 .0 %、 89.8%。颈部转移灶除 N0 者外 ,全消率分别为 75 .7%、 6 4.5 %、 75 .0 %。按临床分期比较消退率 、 、 a期 ,甲组分别为 85 .7%、 71.4%、 6 0 % ,乙组分别为 70 %、 5 8.3%、 6 6 .6 % ,丙组分别为 81.3%、 72 .7%、 6 3.4%。但经统计学处理 ,均无显著性差异 (P >0 .0 5 )。结论 :鼻咽癌综合治疗与单纯放疗疗效比较 ,晚期病例的近期疗效稍有提高 ,长期疗效有待进一步观察。

Clinical study of combination treatment for nasopharygeal carcinoma Ruan

Objective: To study the methods of combination treatment nasopharygeal carcinoma. Methods: 153 patients with nasopharygeal carcinoma were randomly divided into three groups. 49 patients radiotherapy (RT) alone (group A). 52 patients received induction chemotherapy before RT with DDP (50mg,d1,5), 5-Fu (500mg, d1～5) for 2 cycles (group B). 52 patients received chemotherapy with DDP (20mg, d1～5), 5-Fu (500mg, d1～5) in first and fourth week of RT (group C). RT in three groups was similar, patients in convention factionation received 2Gy/per fraction, five fraction/per week, with the total dose of 70～80Gy/7～8 week to nasopharynx, 60～75Gy/6～7.5 week to lymph nose node involvement and 50Gy in regionally lymphatic drainage. Results: Nasopharynx complete remission rate of group A, group B and group C were 90.4%, 75.0% and 89.8% respectively (P＞0.05). Cervical node complete remission rate of group A, group B and group C were 75.7%, 64.5% and 75.0%, respectively (P＞0.05). At Ⅱ stage, CR rate of group A, group B and group C were 85.7%, 70% and 81.3%,respectively (P＞0.05). At Ⅲ stage, CR rate of group A, group B and group C were 71.4%, 58.3% and 72.7%, respectively (P＞0.05). At Ⅳa stage, CR rate of group A, group B and group C were 60%, 66.6 % and 63.4%, respectively (P＞0.05). Conclusions:The near-term results of combination treatment for advanced nasopharygeal carcinoma is better than radiotherapy alone. The long-term survival remains to be answered.