摘要
目的:探讨患者对联合应用诱导化疗和放疗同期口服卡莫氟治疗局部中晚期鼻咽癌疗效和毒副作用。方法:收治66例局部中晚期鼻咽癌患者,随机分为两组,诱导化疗随后放疗组简称为对照组,诱导化疗随后放疗同期卡莫氟治疗组简称为治疗组。两组患者数均为33例。进行根治性放疗前两组患者均接受两个疗程诱导化疗。治疗组在放疗期间同时口服卡莫氟。结果:诱导化疗有效率高,平均有效率高达87%,其中平均完全缓解率(CR)为8.7%、不完全缓解率(PR)为78.4%。对照组鼻咽肿瘤、颈部转移淋巴结全消平均剂量均高于治疗组,统计学有差异。放疗后3个月治疗组鼻咽、颈部转移淋巴结CR均高于对照组(P=0.016,P=0.042)。随访期内治疗组患者局部复发率和远处转移率有降低趋势。临床治疗中出现的主要毒副反应为白细胞下降、口腔粘膜炎、急性放射性皮炎及由卡莫氟引起的热感、尿频、头昏等。结论:放疗同期口服卡莫氟治疗局部中晚期鼻咽癌,降低了鼻咽和颈部肿瘤完全消退的照射剂量,提高了鼻咽肿瘤和颈部转移灶的完全缓解率,局部复发率和远处转移率有下降趋势。尽管加卡莫氟患者毒的副作用加重,但可以耐受,经对症处理绝大部分患者能按计划完成治疗。在鼻咽癌同步化放疗方案中卡莫氟的推荐剂量为600mg/d,分3次口服。放疗同期口服卡莫氟治疗的远期疗效有待于进一步观察。
Objective： To study the impact on the locoregional control and metastasis and acute toxicity in patients with nasopharyngeal carcinoma （NPC） who were treated with 2 cycles of induction chemotherapy （ICT） followed radical radiotherapy alone （RT） and radiotherapy concomitant to HCFU chemotherapy （RTCHC）. Methods： Sixty-six newly diagnosed patients with Stage Ⅲ and IV （Fu Zhou, 1992） NPC were recruited onto two randomized trials, namely, half of them for RT, and half for RTCHC. Both were treated with 2 cycles ICT followed RT and RTCHC. Results： After two circles of induction chemotherapy, the overall response rate of nasopharyngeal tumor and cervical nodal disease were 84.8% and 89.1%, respectively; the complete response rate of nasopharyngeal tumor and cervical nodal disease were 4.5% and 12.7%, respectively, and the partial response of that was 80.3% and 76.4%, respectively. The average complete response dose of nasopharyngeal tumor for RT and RTCHC was 62.0303±7.9039Gy and 54.1515±8.1399Gy （P〈0.01） respectively （P=0.036）, and that of the cervical nodal disease was 60±8.9443 Gy and 49.037±9.4359 Gy respectively （P〈0.001）. After three months of radiotherapy, the complete response rate of 90.9% of nasopharyngeal tumor for RTCHC was more than that of 66.7% for RT （P=0.016）, and that of 92.6% of cervical nodal disease for RTCHC was more than that of 71.4% for RT （P=0.042）. After a median follow-up of 13 months, the locoregional recurrent rates of 3% of the nasopharyngx for RTCHC as less than that of 15.2% for RT （P=0.087）, and that of 3.7% of the neck for RTCHC was less than that of 14.3% for RT （P=0.163）. The systemic metastasis rate of 15.2% for RT was more than that of 6.1% for RTCHC （P=0.230）. Adverse effects, such as leukopenia, mucositis, nausea, dermatitis and so on, were observed in the treated patients. Conclusions： Induction chemotherapy followed radiotherapy concomitant HCFU is effective in the patients with local advanced NPC, thus reduc
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2005年第21期1231-1234,共4页
Chinese Journal of Clinical Oncology
关键词
鼻咽癌
卡莫氟
放疗
诱导化疗
Nasopharyngeal carcinoma
HCFU
Radiotherapy
Chemtherapy
