摘要
目的探讨单纯调强放射治疗或者结合化疗对局部区域晚期鼻咽癌的疗效和相关毒副作用。方法收集2001年9月至2009年10月中山大学肿瘤防治中心收治的经病理证实为WHOⅡ～Ⅲ型初治鼻咽癌患者226例，按与调强放疗结合的不同方式分为单纯放疗组（RT组）67例；顺铂同期放化疗组（CRT组）82例；顺铂＋5-氟尿嘧啶（PF）方案诱导化疗联合顺铂同期放化疗组（PF＋CRT组）77例。调强放疗采用同期整合加量技术治疗。比较各组患者的肿瘤控制情况和治疗毒副作用。结果3组患者中位随访期为70个月，各组患者5年总生存率为67．6％、74．0％、71．1％（P=0．664），无进展生存率为66．9％、72．6％、75．6％（P=0．410），无局部复发率为82．4％、86．4％、86．8％（P=0．447），无远地转移生存率为83．8％、83．8％、85．8％（P=0．827）。化疗组生存率高于单纯放疗组，但生存差异无统计学意义。化疗组3～4级急性毒性反应高于单纯放疗组，差异有统计学意义（P=0．002）。多因素分析结果显示总生存率与临床分期及N分期相关。结论顺铂同期放化疗或联合PF诱导化疗对比单纯调强放射治疗不能显著提高局部区域晚期鼻咽癌患者的生存率，而3～4级急性毒性反应有所增加。
Objective To analyze the effectiveness and toxicity of intensity-modulated radiotherapy （IMRT） combined with chemotherapy or not for locoregionally advanced nasopharyngeal carcinoma. Methods A total of 226 patients with locoregionally advanced nasopharyngeal carcinoma were restrospectively reviewed and classified into three groups ： 67 patients treated by radiotherapy alone （ RT group ） , 82 patients by concurrent chemoradiotherapy （ CRT group ） and 77 patients by cisplatin ＋ 5-fluorouracil （ PF regimen ） combined with CRT （PF ＋ CRT group）. All patients using IMRT technique. Outcomes were overall survival, failure patterns, and toxieities. Results For the RT, CRT and PF ＋ CRT group, the 5-year overall survival rate was 67. 6%, 74% and 71.1% （P =0. 664）, respectively; progress-free survival rate 66. 9%, 72. 6% and 75.6% （P =0. 410） ; relapse-free survival rate 82.4% , 86.4o/0 and 86. 8% （P =0. 447） and distant metastasis-free survival rate 83.8% , 83.8% and 85.8% （P =0. 827）. Significantly more grade 3 -4 acute toxicities happened in patients treated by chemotherapy （ P = 0. 002 ）. Conclusion Comparing with IMRT alone, cisplatin-[MRT or PF regimen induction chemotherapy plus cisplatin-IMRT do not significantly improve survival, but increased grade 3 -4 acute toxicities.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第29期2292-2295,共4页
National Medical Journal of China
关键词
鼻咽肿瘤
放射疗法
计算机辅助
药物疗法
联合
预后
Nasopharyngeal neoplasms
Radiotherapy, computer-assisted
Drug therapy,combination
Prognosis
