放射治疗后加化疗治疗中晚期鼻咽癌的临床观察

１９８９年３月至１９９１年１月，作者将经病理诊断且为初治的１６７例Ⅲ、Ⅳ期鼻咽癌病人，随机分为单纯放疗组和综合治疗组（放疗后加ＣＯＢ方案化疗），进行疗效对比。结果：单纯放疗组８８例的５年生存率为３０．７％，综合治疗组７９例为４０．５％；两个治疗组中的Ⅲ期病人，分别为３８．９％和５２．０％（Ｐ＞０．０５）；两组原发灶及颈淋巴结复发率，复发中位时间基本相同；两组Ⅲ期病人的远处转移发生率分别为２４．０％及３３．３％（Ｐ＞０．０５）；出现远处转移的中位时间，综合组比单纯放疗组延迟（Ｐ＜０．０５）；两组患者的主要死亡原因为复发和转移，两组死亡病例的中位生存期，综合组长于单纯放疗组（Ｐ＜０．０５）；远期后遗症的发生率，综合组高于单纯放疗组（Ｐ＜０．０１）。

The Clinical Study of Chemotherapy After Radiotherapy in Patients with Intermediate and Late Nasopharyngeal Carcinoma

From March 1989 to January 1991, 167 cases with the third and fourth stage nasopharyngeal carinoma were divided randomly into two groups for contrast of therapeutic effect. These patients were all diagnosed by pathology and underwent primary treatment. Among them, 88 cases (the first group)only recerived radiotherapy, 79 cases(the second group)received combined treatment (chemotherapy of COB plan after radiotherapy). The results showed: the survival rate of 5 years in the first group was 30.7% and it was 40.5% in the second group. The survival rate of 5 years of third stage patients in two groups was 38.9% and 52.0%( P >0.05) respectively The recurrence rate of primary focus and lymphonodi cervicales and the median time of recurrence were roughly the asme. The distant metastasis occurrence rate in the third stage patients of two groups was 24.0%and 33.3%( P >0.05)respectively. The median time of distant metasis in the second group was longer than that in the first guoup ( P <0.05),the main reasons of death in two groups were recurrence and metastasis, the average surrival time of death patients in the second group was longer than that in the first proup ( P <0.05),the late sequel occurrence rate of radiotherapy in the second group was higher than that in the first group ( P <0.01).