同期放化疗与单纯放疗治疗中晚期鼻咽癌的近期疗效

目的:评价同期放疗加化疗治疗中晚期鼻咽癌的近期疗效及化疗对放疗副反应的影响。方法:149例初治中晚期鼻咽癌随机分为实验组74例及对照组75例。实验组:采用顺铂与亚叶酸、氟尿嘧啶化疗4周期(分别在放疗前、中、后)。两组的放疗方法及剂量相同,鼻咽部72Gy～78Gy,颈部有淋巴结转移者根治量64Gy～70Gy,颈部预防量50Gy～54Gy。结果:放疗结束时及治疗结束后3个月实验组的鼻咽部及颈部的肿瘤完全消退率均比对照组高,(P<0.05)。实验组出现口腔溃疡、咽喉疼痛、伴吞咽困难及需暂停放疗的发生率比对照组高(P<0.05)。结论:同步放化疗可明显提高晚期鼻咽癌颈部病灶及颈部淋巴结转移灶的消退率,但可加重放疗的不良反应。

Study of Concurrent Chemoradiotherapy and Radiotherapy Alone for Advanced Nasopharygeal Carcinoma

Objective Nasopharyngeal carcinoma(NPC) is a radiosensitive and chemosensitive tumor.The aim of this prospective study is to evaluate the efficacy and toxicity of concurrent chemoradiotherapy for advanced NPC.Methods From March 1998 to Augest 2004, 149 cases NPC were randomly allocated into two arms.Similar dosage and fractionation of radiotherapy was administered in both arms.The investigational arm(74 cases) received four cycles of concurrent chemotherapy with cisplatin plus 5-fluorouracil plus leucovorin,during the before and middle and last of radiotherapy.Results The complete response rates of primary tumor and neck nodes in the investigational arm are significantly higher than in the radiotherapy alone arm,P<0.05.The toxicity rates of radiotherapy in the investigational arm are significantly higher than in the radiotherapy alone arm,P<0.05.Conclusion The method of investigational arm is an effective and well-tolerated regimen in the treatment of locally advanced NPC,although there is very much toxicity during radiotherapy.