摘要
目的评价时辰化疗联合调强放疗治疗局部晚期鼻咽癌的远期疗效和安全性。方法采用随机数字表法,将160例局部晚期鼻咽癌患者随机分为时辰组和常规组,每组80例。时辰组采用TPF方案[多西他赛+顺铂(DDP)+氟尿嘧啶]时辰诱导化疗2个周期,每周期21 d。诱导化疗结束3周后,行调强放疗(IMRT)同步DDP方案化疗。化疗从放疗的第1天开始,每周期21 d,直到放疗结束,共3个周期。常规组常规行TPF方案诱导化疗和IMRT同步DDP方案化疗。同步放化疗结束后,中位随访31个月,观察远期不良反应和患者生存情况。结果时辰组听力损伤、吞咽困难和颈部皮肤纤维化的发生率分别为22.72%、0和4.54%,均明显低于常规组(分别为39.13%、8.69%和15.94%,均P<0.05)。时辰组和常规组患者的1年总生存率分别为97.0%和92.8%,3年总生存率分别为80.3%和81.2%;1年无进展生存率分别为95.5%和87.0%,3年无进展生存率分别为71.2%和73.9%;1年无局部复发生存率分别为97.0%和95.7%,3年无局部复发生存率分别为92.4%和92.8%;1年无远处转移生存率分别为97.0%和98.6%,3年无远处转移生存率分别为90.9%和91.3%,差异均无统计学意义(均P>0.05)。结论与常规化疗联合IMRT相比,时辰化疗联合IMRT治疗局部晚期鼻咽癌并不降低患者的远期生存,但能降低不良反应的发生率。
Objective To evaluate the long-term effect and safety of chrono-chemotherapy combined with intensity modulated radiotherapy(IMRT)in locally advanced nasopharyngeal carcinoma(NPC).Methods 160 patients with locally advanced NPC were randomly divided into a chrono group and conventional group according to random number table.In the first stage,all patients underwent two cycles of induced chemotherapy,consisting of docetaxel,cisplatin and 5-Fu every 21 days.Notably,patients received chrono-moduated chemotherapy according to circadian rhythm in the chrono group,and conventional chemotherapy in the conventional group.Then,21 days after the completion of first stage,three cycles of concurrent cisplatin chemotherapy every 21 days were given to all patients during IMRT.The median follow-up after the completion of radiotherapy was 31 months.Long-term side effects and the survival of patients were observed.Results Patients in the chrono group had significantly lower rates of hearing loss(22.72%),dysphagia(0)and neck fibrosis(4.54%)compared with those in the conventional group(39.13%、8.69%,15.94%,respectively,all P<0.05).Meanwhile,the 1-year overall survival rates(97.0%vs 92.8%),3-year overall survival rates(80.3%vs 81.2%),1-year progression free survival rates(95.5%vs 87.0%),3-year progression free survival rates(71.2%vs 73.9%),1-year locoregional relapse-free survival rates(97.0%vs 95.7%),1-year locoregional relapse-free survival rates(92.4%vs 92.8%),1-year distant metastasis-free survival rates(97.0%vs 98.6%)and 3-year distant metastasis-free survival rates(90.9%vs 91.3%)between the chrono group and the conventional group were not statistically significant(all P>0.05).Conclusions Compared with conventional chemotherapy,chrono-chemotherapy combined with IMRT didn′t affect long-term survival,but reducing the incidence of adverse events in patients with locally advanced NPC.
作者
刘宽奇
金风
江杭
吴伟莉
李媛媛
龙金华
罗秀玲
龚修云
陈潇潇
刘丽娜
甘家应
周建奖
Liu Kuanqi;Jin Feng;Jiang Hang;Wu Weili;Li Yuanyuan;Long Jinhua;Luo Xiuling;Gong Xiuyun;Chen Xiaoxiao;Liu Lina;Gan Jiaying;Zhou Jianjiang(Department of Oncology,the Affiliated Cancer Hospital of Guizhou Medical University,Guiyang 550000,China;Department of Head and Neck Oncology,the Affiliated Cancer Hospital of Guizhou Medical University,Guiyang 550000,China;Department of Radiotherapy Technology,the Affiliated Cancer Hospital of Guizhou Medical University,Guiyang 550000,China;Laboratory of Molecular Biology,Guizhou Medical University,Guiyang 550001,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2020年第2期133-138,共6页
Chinese Journal of Oncology
基金
国家自然科学基金(8156100022)
贵州省科技厅创新群体重大研究项目(黔教合KY字[2017]038)
贵州省科技计划项目(黔科合SY字[2015]3049)。
关键词
鼻咽肿瘤
时辰化疗
调强放疗
不良反应
生存
Nasopharyngeal neoplasms
Chrono-chemotherapy
Intensity modulated radiotherapy
Adverse event
Survival
