单纯放疗及放疗联合每周顺铂治疗局部晚期鼻咽癌的前瞻性研究

目的比较单纯放疗及放疗联合每周顺铂方案治疗局部晚期鼻咽癌（LANPC）的急性和晚期反应及其疗效。方法将52例局部晚期鼻咽癌患者随机分入单纯放疗组（RT组）及放疗联合化疗组（CRT组）,两组患者均接受常规放射治疗,CRT组于放射治疗的第1周起静脉滴注顺铂30mg/m^2,每周1次,连续5～7周。结果52例患者均完成了计划剂量的放射治疗,25例患者完成了同期顺铂治疗,急性毒副反应的发生率与RT组相比,差异无统计学意义（P〉0.05）,两组均未观察到3、4组正常组织的晚期损伤。治疗后3个月时完全缓解率两组间差异无统计学意义（P〉0.05）。中位随访48.8个月后,2、4年总生存率、无转移生存率两组间差异有统计学意义（P〈0.05）;而两组无复发生存率未见明显差异（P〉0.05）。结论每周30 mg/m^2顺铂联合放射治疗与单纯放疗相比,能提高局部晚期鼻咽癌患者的生存率,降低远处转移率,同时急性放射反应和晚期放射损伤在患者可接受范围内。

Randomized Trial of Radiotherapy Versus Radiotherapy Concurrently with Weekly Cisplatin for Treatment of Locally Advanced Nasopharyngeal Carcinoma

Objective To observe the acute and late toxicities of radiotherapy alone and radiotherapy concurrently with weekly eisplatin in patients with locally advanced nasopharyngeal cancer（LANPC） ,and analyse the efficacy. Methods From January 2001 to December 2005,52 patients with LANPC were randomly assigned to receive radiotherapy（RT） alone （n = 26） or radiotherapy concurrently with weekly cisplatin（CRT） （n =26）. The patients in both arms received 66 -70 Gy in 7 weeks using standard RT portals and techniques. Cisplatin 30 mg/m^2 was administered weekly for 5 -7 cycles to patients in CRT from the first week of radiotherapy. The overall response and survival rates were calculated. Results All patients were eligible for toxicity and response analysis. 100% of the patients completed the planned radio-therapy, while full cycles treatment of cisplatin were given to 96% of the patients. Rare high-grade acute and late toxicity was observed in CRT and RT. There was the rate of completely relief in three month after treatment months, there were significant differences observed between no significant difference between two arms on （ P 〉 0.05 ）. After a median follow-up of 48.8 two arms （P 〉 0.05） in the 2-year,4-year overail survival （OS） and metastasis-free survival （MFS）. Conclusion Radiotherapy concurrently with weekly cisplatin 30 mg/m^2 is well tolerable and improves OS rate and the distant metastasis control in LANPC.