中晚期鼻咽癌新辅助化疗联合放疗的临床研究

目的:探讨新辅助化疗联合放疗治疗中晚期鼻咽癌的疗效。方法:自1998年1月至2002年11月,92例中晚期鼻咽癌患者分别采用新辅助化疗联合放疗(化放组)及单纯放疗(单放组)。新辅助化疗组在放疗前给予DDP 5-Fu化疗2周期,二组放疗相同。鼻咽DT(68~72)Gy/(7~7.5)W,颈部50Gy~76Gy/(5~8)W,比较二组疗效及不良反应。结果:放疗结束时鼻咽肿瘤完全退缩率二组分别为60.4%,38.6%(P<0.05),颈部淋巴结完全退缩66.7%,36.4%(P<0.05),急性反应化放组的胃肠道反应,白细胞下降等副反应增加。1年生存率化放组及单放组分别为81.3%,81.8%(P>0.05),3年生存率分别为58.3%,61.3%(P>0.05)。结论:新辅助化疗联合放疗治疗中晚期鼻咽癌能提高近期鼻咽病灶及颈淋巴结完全消退率,未能提高中晚期病人的生存率,未能降低远处转移的几率。

Clinical study of neoadjuvant chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma

Objective:To research the effects of neoadjuvant chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma. Methods: From January 1998 to November 2002, 92 cases of nasopharyngeal carcinoma were devided into two groups. The patients of group A were treated by neoadjuvant chemotherapy before radiotherapy (n=48). The patients of group B were treated by radiotherapy alone (n=44). Both groups were given the same radiotherapy. Group A received 2 cycles of chemotherapy of PF regimen (5-Fu and DDP). They were treated with radiotherapy received DT (68~72)Gy/(7~7.5)W to the nasopharyngx and DT (50~76)Gy/(5~8)W to the neck. Results: After therapy the complete response rate for primary tumor were 60.4% in the neoadjuvant chemotherapy combined with radiotherapy (group A), and 38.6% in group B. The remission rates in the cervical lymph nodes were 66.7% VS 36.4%, with significant difference (P<0.05).The occurring of leucocytte declining and membrance reaction in group A were more than those in group B. The one-year survival rates were 81.3% in group A and 81.8% in group B. The 3-year survival rate were 58.3% in group A and 61.3% in group B, without significant difference (P>0.05). Conclusion: Neoadjuvant chemotherapy combined with radiotherapy can increase the local disease control in the patients with advanced nasopharyngeal carcinoma . But it failed to gain the survival benefit and reduce distant metastases.