摘要
目的探讨同期放化疗能否提高Ⅲ-Ⅳa期鼻咽癌的疗效。方法92例Ⅲ-Ⅳa期鼻咽癌患者随机分为两组。A组,单纯常规放疗组46例。B组,常规放疗＋同期化疗46例。两组放疗方案相同均选用6MVX线外照射或6-12MeV电子线（用于颈部淋巴结转移灶的剂量补充照射）放射技术为面颈联合野DT38Gy后,改耳前野避开脊髓加量及颈部切线野、上颈电子线外照射。原发灶和阳性淋巴结区DT70-76Gy/35-38次,7-8周,预防区DT50-60Gy/25-30次,5-6周。化疗方案为DDP40mg静脉滴注,d1-3,平阳霉素16mg静脉滴注,d1-3,每4周为1个疗程,共2个疗程,放射治疗开始于化疗结束后第2天进行。结果3年无瘤生存率（DFS）A组47.8%（22/46）、B组71.7%（33/46）,两者差异有统计学意义（χ^2=5.47,P〈0.05）。3年总生存率（OS）A组58.7%（27/46）,B组73.9%（34/46）,两者差异无统计学意义（χ^2=2.38,P〉0.05）。结论同期放化疗能提高中晚期鼻咽癌的无瘤生存率,对总生存率的提高也有一定的帮助。毒副反应虽有增加,但患者均能耐受。
Objective To evaluate the efficacy of concurrent chemotherapy and radiotherapy for Ⅲ-Ⅳa nasopharyngeal carcinoma. Methods From Oct. 200i to Oct. 2002, 92 patients of stage Ⅲ-Ⅳa nasopharyngeal carcinoma were randomized into radiotherapy alone group （A group, 46 patients） or concurrent chemotherapy group （ B group, 46 patients）. All patients of A and B groups received radiotherapy by 6 MV X-ray or 6-12 MeV 13-ray. Radiotherapy was delivered by 6 MV X-ray facial-cervical part was first used to give DT 38 Gy followed by pro-auricular fields or neck fields. The dose at the primary lesion and metastastic lymph node were usually DT 70-76 Gy/35-38 fractionation in 7-8 weeks. DT 50-60 Gy was used prophylactically for the neck region which had been from metastasis. Before radical radiotherapy patients of B group received cisplatin（DDP） 40 mg on days 1-3 and bleomycin A5 16 mg on days 1-3 every four weeks as one cycle to totally 2 cycles. Radiotherapy was used after second day of completed chemotherapy. Results The 3-year disease-free survival rates （DFS） were 47.8% （22/46） in A group, 71.7% （33/46） in B group respectively. Two groups had difference （P 〈 0.05 ）. The 3-year overall survival rate （OS） were 58.7% （27/46） in A group, 73.9% （34/46） in B group. Two groups had no difference （P〉0.05）. Conclusions Concurrent chemotherapy and radiotherapy for Ⅲ-Ⅳa nasopharyngeal carcinoma can improve disease-free survival rates（DFS） and help to improve overall survival rate （OS）. Although the toxicities had increase, the patients can he tolerated.
出处
《肿瘤基础与临床》
2008年第1期55-56,共2页
journal of basic and clinical oncology
关键词
鼻咽癌
放射治疗
化学治疗
nasopharyngeal carcinoma
radiotherapy
chemotherapy
