Ⅰ/Ⅱ期鼻咽癌放疗联合同期化疗的临床结果分析

The clinical trail of hyperfractionated radiotherapy combined with chemotherapy concurrently treatment the stage Ⅰ/Ⅱ nasopharynx cancer

目的 探讨放疗联合同期化疗治疗Ⅰ /Ⅱ期鼻咽癌病例的生存率和并发症。方法 回顾性分析两组共 13 8例Ⅰ /Ⅱ期鼻咽癌病例 ,分为放疗联合同期化疗组 (研究组 )和单纯放疗组 (对照组 ) ,两组采用相同的放疗方法 ,研究组加用以铂类药物为主的化疗方案 ,均为 2个周期 ,对照组仅接受单纯放疗。结果 研究组和对照组中的Ⅰ期病例 5年生存率分别为 83 .71%和 71.2 0 % (P =0 .5 0 0 4) ,Ⅱ期病例 5年生存率分别为 65 .2 2 %和 5 6.14 % (P =0 .5 991) ,均无统计学差异 ,研究组中N0 和N1病例的 5年生存率分别为 89.2 1%和 44 .16% (P =0 .0 0 15 ) ,对照组中N0 和N1病例的 5年生存率分别为 76.0 5 %和 5 5 .41% (P =0 .0 0 99) ,均存在显著统计学意义。结论 Ⅰ /Ⅱ期鼻咽癌病例回顾性分析放化同步治疗其生存率改善无明确临床证据 ,是否应接受同步化疗还有待前瞻性试验进一步研究。

Objective To investigate the responeses and side-effets of hyperfractionated radiotherapy combined with chemotherapy concurrenthy treatment for stage Ⅰ/Ⅱ nasopharynx cancer.Methods 138 cases with stageⅠ/Ⅱ nasopharynx were devided into two groups.The patients in treatment group received hyperfractionated radiotherapy combined with 2 courses DDP-based regimen chemotherapy concurrently,while the patients in control group were given hyperfractionated radiotherapy only. Patients in both groups received the same as technique with the hyperfractionated radiation.Results The overall 5-year survival rates of patients with stage Ⅰ nasopharynx in treatment group and control were 83.71% and 71.20%,respectively(P=0.5004).Those rates of patients with stage Ⅱ nasopharynx in treatment group and control group were 65.22% and 56.14%,respectively(P=0.5991).There were no evidence that the two groups had any statistical significance.But in treatment group,the overall 5-year survival rates of patients with and without lymph node metastasis were 89.21% and 44.16%,respectively(P=0.0015).And in control group,those rates of patients with and without lymph metastasis were 76.05% and 55.41%,respectively(P=0.0099).There was significante difference between the patients with and without lymph note metastasis.Conclusion Whether the patients with stage Ⅰ/Ⅱ nasopharynx cancer need chemotherapy and what is the best regimen and space of chemotherapy need further investigation.