放疗联合不同方式化疗治疗中晚期鼻咽癌的近期疗效观察

目的　对比观察诱导化疗联合后程加速超分割放疗 (诱导组 )和同时期化疗联合后程加速超分割放疗 (同期组 )治疗中晚期鼻咽癌的毒副反应、有效率及生存率。方法　 3 2例中晚期鼻咽癌应用羟基喜树碱 (HCTP)诱导化疗联合后程加速超分割放射治疗 ,48例类似病人应用DDP加 5 Fu化疗同期联合后程加速超分割放射治疗。结果　诱导组总有效率 10 0 % ,其中CR87.5 % (2 8/3 2 ) ,同期组总有效率 10 0 % ,其中CR85 .42 % (4 1/4 8) ,两组之间无显著性差别 (P =0 .79) ;但经CT检查证实鼻咽肿瘤完全消退率同期组达 75 .76% ,而诱导组仅 42 .1% ,同期组比诱导组高 (P =0 .0 3 ) ;1年生存率 :诱导组为 93 .8% (3 0 /3 2 ) ,同期组为 91.7% (4 4 /4 8) ,两组之间差别无显著性意义 (P =0 .93 )。但诱导组的毒副反应比同期组轻 (P <0 .0 5 )。结论　HCTP诱导化疗联合后程加速超分割放疗与DDP加 5 Fu化疗同期联合后程加速超分割放射治疗对中晚期鼻咽癌的疗效无差异 ,但前者毒副反应较轻。

Short term effect of radiotherapy combined with different modals of chemotherapy for advanced nasopharyngeal carcinoma(NPC)

ObjectiveTo compare the toxic reaction,therapeutic effect and survival rate between neoadjuvent-chemotherapy and concurrent-chemotherapy while late course accelerated hyperfractionation radiotherapy being taken for advanced NPC.Methods32 patients with advanced NPC were treated with hydroxy camptothecine(HCPT)neoadjuvent-chemotherapy and late course accelerated hyperfractionation radiotherapy(neoadjuvent group).48 patients were randomly chosen to receive DDP+5-Fu concurrent-chemotherapy and late course accelerated hyperfractionation radiotherapy (concurrent group).ResultsThe total response rate and CR rate were 100% and 87.5%(28/32) in neoadjuvent group,and 100% and 85.42%(41/48) in concurrent group(P=0.79) respectively.The complete response rate of CT scan in the nasopharynx was 75.76% in concurrent group which was higher than the 42.1% in neoadjuvent group(P=0.03).The 1-year survival rates were 93.8%(30/32) in neoadjuvent group and 91.7%(44/48) in concurrent group,respectively(P=0.93).However the toxic reaction was lower in neoadjuvent group than that in concurrent group (P<0.05).ConclusionThe present study indicates that HCPT neoadjuvent-chemotherapy results in lower radiation reaction than that DDP+5-Fu concurrent-chemotherapy though there is no significantly statistic difference on the therapeutic effect and survival rate between the two groups.