PF方案新辅助化疗加局部放疗治疗T_4N_0M_0鼻咽癌近期疗效观察

Short-term efficacy of radiotherapy alone versus radiotherapy followed by new adjuvant chemotherapy in treatment of T_4N_0M_0 nasopharyngeal carcinoma

目的比较单纯放疗与PF方案新辅助化疗+局部放疗T4N0M0鼻咽癌的临床疗效和毒副作用。方法64例T4N0M0鼻咽癌患者随机分为两组,32例行单纯放射治疗(单放组),32例接受PF(DDP+5-Fu)方案新辅助化疗,2个疗程后加放疗(PF组)。结果单放组和PF组在半量(36Gy)时鼻咽病灶有效率(PR+CR)分别为53.1%和68.7%(P>0.05);全量放疗结束时鼻咽病灶有效率(PR+CR)分别为81.2%和93.7%(P>0.05)。放疗毒副作用所致恶心、呕吐和骨髓抑制等差异均有显著性(P<0.05)。结论PF方案新辅助化疗加局部放疗治疗T4N0M0鼻咽癌较单纯放疗局控率较好,但前者毒副作用较重。

Objective To compare local control efficacy and toxicity of radiotherapy（RT） followed by new adjuvant chemotherapy（NC） versus radiotherapy alone in treatment of patients with T4N0M0 stage Ⅳ nasopharyngeal carcinoma（NPC）. Methods From 2000 to 2004,62 stage T4N0M0 NPC patients were randomized into RT alone group and RT followed by NC group. The patients in the two groups were comparable in age,gender,stage and pathology. The NC group was treated with two courses of NC with DDP and 5-Fu before RT. Results The local control rates were 53. 1% for RT group and 68.7% for NC group at the dose of 36 Gy（ P 〉 0.05 ）. At the total dose, the local control rates were 81. 3% for RT group and 93.8% for NC group（ P 〉 0.05 ）. There was significant difference between the two groups in toxicity, such as nausea,vomiting and myelosuppression. Conclusion NC can significantly improve short-term efficacy and local control rates, but it has much toxicity.