诱导化疗联合放疗在中晚期鼻咽癌治疗中的临床应用

目的评价诱导化疗联合放疗对中晚期鼻咽癌的客观疗效及毒副反应.方法 90例病理证实的鼻咽癌病例随机分为常规放射治疗组(45例)及诱导化疗 放疗组(45例).常规放射治疗:鼻咽原发灶DT 70 Gy,颈部预防照射DT 50 Gy,转移灶DT 65～70 Gy;诱导化疗:第1～5天行DDP 20 mg、5-Fu 500 mg静脉滴注.结果化疗加放疗组和单放组治疗后,3个月鼻咽肿瘤消退率分别为91.11%、93.33%和82.22%、84.44%(P<0.05),颈淋巴结肿大消退率分别为77.78%、84.44%和62.22%、66.67%(P<0.05).结论对中晚期鼻咽癌行放、化疗联合有助于提高局部控制率.

Induction chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma

Objective To evaluate the effects of induction chemotherapy combined with radiotherapy in the treatment of patients with advanced nasopharyngeal carcinoma. Methods A total of 90 patients with nasopharyngeal carcinoma confirmed pathologically were randomized into two groups: radiotherapy (n=45) and induction chemotherapy plus radiotherapy (n=45). The primary tumor received a total dose of 70 Gy at the daily dose of 2 Gy. Patients who had cervical lymph node metastasis received 65-70 Gy to the neck whereas patients who did not have cervical lymph node metastasis received a prophylactic radiation of 50 Gy. The regimen of induction chemotherapy consisted of cisplatin (20 mg, iv infusion at 1-5 d) and 5-Fu (500 mg, iv infusion at 1-5 d). Results The complete response rates for the primary tumor were 91.11% and 93.33% in the chemotherapy plus radiotherapy group and 82.22% and 84.44% in the radiotherapy group after treatment and at 3 months after treatment (P<0.05). The remission rates in the cervical lymph nodes were 77.78% and 84.44% in the chemotherapy plus radiotherapy group and 62.22% and 66.67% in the radiotherapy group (P<0.05). Conclusion Induction chemotherapy combined with radiotherapy may increase local disease control in patients with advanced nasopharyngeal carcinoma.