化疗综合放射治疗鼻咽癌双肺转移49例分析

目的探讨全肺放疗加后程三维适形局部放射治疗对双肺多发转移的鼻咽癌的临床疗效。方法回顾性分析49例全肺多发转移的鼻咽癌患者，全部病例的原发病灶均经病理证实。其中30例（称化放组）采取PF方案化疗结合全肺放疗加后程三维适形局部放射治疗。其余19例患者（称化疗组）只行PF化疗。结果经治疗后，放化组患者疗效高于化疗组；放化组1、2、3年生存率高于化疗组。化放组粒细胞减少症66．7％，均1—2级，放射性肺炎46．7％，均1～2级，未发现放射性食管炎。经对症治疗后症状消失。结论化疗结合全肺放疗加后程三维适形局部放疗可明显改善双肺多发转移癌患者近期疗效，提高患者长期生存率，延长生存时间，毒副作用可耐受。

Treatment of nasopharyngeal carcinoma With bilateral pulmonary metastasis with chemotherapy and radiotherapy

Objective To evaluate the therapeutic effect of chemotherapy and whole-lung conventional radiotherapy and three dimensional conformal radiotherapy on latter course on nasopharyngeal carcinoma with bilateral pulmonary metastasis. Methods 49 patients with nasopharyngeal carcinoma （ NPC ） with multiple bilateral pulmonary metastasis were analyzed, which were confirmed by pathological examination. 30 patients （ chemoradiotherapy group ） were treated with DF chemotherapy and conventional radiotherapy. The other 19 cases （chemotherapy group） were treated with DF chemotherapy. Result CR, DR, SD and PD and the 1, 2, and 3 years survival rate of chemoradiotherapy group were higher than that of chemotherapy group. The complications including granulocytopenia radiation pneumonitis were is 66.7% （ 14/30 ） and 46.7% （ 14/30 ） , respectively. Conclusions DF Chemotherapy and whole-lung conventional radiotherapy and three dimensional conformal radiotherapy on latter course can significantly improve the of patients with bilateral pulmonary metastasis and attenuate the side effects.