中晚期鼻咽癌诱导化疗疗效评价

目的:探讨诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的安全性有效性。方法:收集2008年10月至2010年6月共68例局部晚期鼻咽癌患者(Ⅲ,Ⅳa,92分期),随机分为A组诱导化疗+同步放化疗组和B组同步放化疗组,A组35例患者行2个疗程的TP方案诱导化疗,然后行单药DDP同步放化疗,B组33例患者直接行单药顺铂同步放化疗,对照研究观察两组患者的局部控制率及远处转移率,并观察患者总生存率。结果:68例所有的患者完成了计划剂量的治疗计划。诱导化疗结束后,鼻咽完全缓解率为17.1%,颈部淋巴结完全缓解率为31.4%。诱导化疗并同步放疗结束3个月后,鼻咽完全缓解率为94.3%,颈部淋巴结完全缓解率为88.8%。以TP方案行诱导化疗患者耐受性好,局部控制率及远处转移率均较单纯同步放化疗组低。结论:以诱导化疗联合同期放化疗的方式治疗局部晚期鼻咽癌方式,患者耐受性好,且能获得较好的治疗效果。

Clinical observation on the results of patients with local advanced nasopharyngeal carcinoma treated with induced chemotherapy plus concurrent chemotherapy and radiotherapy

Objective:To evaluate the short-term effects and adverse effects of induced chemotherapy plus concurrent radiochemotherapy on local advanced nasopharyngeal carcinoma(NPC).Methods:A total of 68 patients with local advanced NPC(stage III or IVa),treated from Oct.2008 to Jun.2010,were randomly divided into induced chemotherapy plus concurrent radiochemotherapy group(group A)and concurrent radiochemotherapy group(group B).Induced chemotherapy(TP for 2 cycles)and cisplatin alone concurrent radiotherapy was performed in group A(35 cases),cisplatin alone concurrent radiotherapy was performed in group B(33 cases).The local control ratio(LCR)and distant metastasis rate were compared,and the overall survival(OS)was observed.Results:All 68 patients had completed the treatment.Among group A,the complete response rate of nasopharynx was 17.1% after induced chemotherapy,the complete response rate of cervical lymph node was 31.4%.The complete response rate of nasopharynx was 94.3% at 3 months after radiotherapy,and the cervical lymph node was 88.8%.They can tolerate the most toxicities of induced chemotherapy.During the concurrent radiochemotherapy.Conclusion:The induced chemotherapy plus concurrent radiochemotherapy for patients with local advanced NPC has higher short-term effects and has been well tolerated.