奥沙利铂联合氟尿嘧啶同期调强适形放疗治疗局部晚期鼻咽癌疗效观察

目的]探讨奥沙利铂联合氟尿嘧啶同期调强适形放疗治疗局部晚期鼻咽癌的临床疗效.方法]选自本院于2012年5月至2014年5月期间收治的局部晚期鼻咽癌患者82例,依据随机数表法分为观察组与对照组各41例.两组患者均采用三维调强适形放疗.对照组在调强放疗基础上同期采用顺铂化疗,观察组在调强放疗基础上同期采用奥沙利铂联合氟尿嘧啶化疗.两组均以21d为1个周期,连续2~4个周期.比较两组近期疗效,1年和3年局部复发情况、远处转移情况和生存情况及毒副反应发生情况.结果]两组近期总有效率均为100.00%,差异无统计学意义(P>0.05);两组1年局部复发率比较无统计学差异(P>0.05).观察组3年局部复发率低于对照组(P<0.05);两组1年远处转移率比较无统计学差异(P>0.05);观察组3年远处转移率低于对照组(P<0.05);两组胃肠反应、肝功能、肾功能及口腔黏膜反应发生率比较差异无显著性(P>0.05);两组1年生存率比较无统计学差异(P>0.05);观察组3年生存率高于对照组(P<0.05).结论]奥沙利铂联合氟尿嘧啶同期调强适形放疗对局部晚期鼻咽癌患者疗效显著,可降低局部复发和远处转移,延长生存时间,值得临床推广应用.

Clinical Observation of Oxaliplatin Combined with 5-fluorouracil Concurrent Intensity-modulated Radiotherapy in Patients with Locally Advanced Nasopharyngeal Carcinoma

Objective]To evaluate the efficacy of oxaliplatin combined with 5-fluorouracil concurrent intensity-modulated radiotherapy(IMRT)for locally advanced nasopharyngeal carcinoma(NPC).Methods]Eighty-two pa-tients with locally advanced nasopharyngeal carcinoma who were treated in our hospital from May 2012 to May 2014 were randomly divided into observation group(41 cases)and control group(41 cases).The two groups of patients were treated with three-dimensional conformal intensity-modulated radiation therapy(IMRT).The control group was treated with cisplatin on the basis of IMRT.The observation group received oxaliplatin combined with 5-fluorouracil on the basis of IMRT.The two groups were treated 21 d for 1 cycle,continuous 2~4 cycles.The short-term efficacy of the two groups,the local recurrence,distant metastasis and survival in 1 and 3 years,and the occurrence of side effects were compared.Results]The total effective rate in the two groups was 100%,there was no statistically significant difference between the two groups(P>0.05);1-year local recurrence rate showed no significant difference(P>0.05);3-years local recurrence rate of the observation group was lower than that of the control group(P<0.05);1-year distant metastasis rate of the two groups showed no significant difference (P>0.05);3-year distant metastasis rate of the observation group was lower than that of the control group(P<0.05);gastrointestinal reaction,liver function,renal function and oral mucosa reaction rate of the two groups had no significant difference(P>0.05);1-year survival rate of the two groups had no significant difference(P>0.05);3-year survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion] Oxaliplatin combined with 5-fluorouracil concurrent intensity-modulated radiotherapy is effective in the treatment of locally advanced nasopharyngeal carcinoma.It can reduce local recurrence and metastasis,and prolong the survival time,which is worthy of clinical application.