摘要
背景与目的:诱导化放疗与同时期化放疗被认为是治疗局部晚期鼻咽癌最有效的两种策略。本随机研究目的在于比较诱导化疗加同时期化放疗与诱导化放疗治疗局部区域晚期鼻咽癌的疗效。方法:从2002年8月到2005年4月,408例患者随机分为诱导化放疗(induction chemoradiotherapy,IC/RT)和诱导加同时期化放疗(induction-concurrent chemoradiotherapy,IC/CCRT)两组。两组患者接受同样的诱导化疗方案:两程氟尿嘧啶脱氧核苷(floxuridine,FuDR)(750mg/m2,d1-5)+卡铂(carboplatin,CBP)(AUC=6),化疗结束后1周行放疗。诱导加同时期化放疗组的患者在在放疗的第7、28、49d接受卡铂AUC=6的化疗。8例不符合入组标准的患者被排除。剩余的400例患者被纳入进行了分析。结果:诱导加同时期化放疗组和诱导化放疗组Ⅲ、Ⅳ度毒性率分别为28.4%和13.1%(P<0.001)。中位随访3.9年,诱导加同时期化放疗组和诱导化放疗组的3年总生存分别为75.9%和83.4%(P=0.12)。两组的无病生存、局部区域控制和远处转移控制率无统计学差异。结论:本研究采用的诱导加同时期化放疗方案未能较诱导化放疗进一步提高局部区域晚期鼻咽癌患者的总生存率。
Background and Objective： Induction chemotherapy and radiotherapy or concurrent chemoradiotherapy are the most two effective treatments for patients with Iocoregionally advanced nasopharyngeal carcinoma （NPC）. This study was to compare the efficacy of induction- concurrent chemoradiotherapy versus induction chemotherapy and radiotherapy for patients with Iocoregionally advanced NPC. Methods： From August 2002 to April 2005, 408 patients were randomly divided into the induction-concurrent chemoradiotherapy （IC/CCRT） group and the induction chemotherapy and radiotherapy （IC/RT） group. Patients in both groups received the same induction chemotherapy, including two cycles of floxuridine （FuDR） plus carboplatin （FuDR 750 mg/m^2, d1-5; carboplatin AUC=6）. All the patients underwent radiotherapy one week after completing the induction chemotherapy. The patients in the IC/CCRT group also received carboplatin （AUC=6） on day 7, 28, and 49 during radiotherapy. Eight patients did not meet the inclusion criteria and were excluded. The remaining 400 cases were analyzed. Results： Grade III/IV toxicity was found in 28.4% of the patients in the IC/ CCRT group and 13.1% in the IC/RT group （P 〈 0.001 ）. After a median follow up time of 3.9 years, the three-year overall survival was 75.9% and 83.4% （P=0.12） in the IC/CCRT and IC/RT groups, respectively. No significant differences in the failure-free survival rate, the Iocoregional control rate, and the distant control rate were found between the two groups. Conclusion. The IC/CCRT program does not improve the overall survival rate in patients with Iocoregionally advanced NPC compared with the IC/RT program.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2009年第10期1033-1042,共10页
Chinese Journal of Cancer
关键词
鼻咽肿瘤
化学治疗
放射治疗
nasopharyngeal neoplasm, chemotherapy, radiotherapy
