局部晚期鼻咽癌三种治疗模式比较研究

Comparative investigation of three trentments in regionally-advanced nasopharyngeal carcinoma

目的探讨三种模式治疗局部晚期鼻咽癌的临床疗效、治疗反应及生存质量。方法2001年1月至2002年6月初治的病理确诊的局部晚期鼻咽癌120例随机分为两组:同期放化疗(RC)组60例,放疗每周照射5d,1次/d,200cGy/次,总剂量7000～8000cGy,化疗方案为5-氟脲嘧啶(5-Fu)+顺铂(DDP),在放疗第1、4周各用1周期;放疗艾迪(RAD)组60例,放疗方式同RC组,用艾迪注射液50ml静脉滴注,连用10d为l周期,间隔7d重复,共用3个周期。同期由于各种原因仅单纯放疗(R)而临床资料与上述两组具有可比性的患者60例作为对照组。观察各组治疗效果和放射反应。结果随访3年,RC组和RAD组3年生存率近似(73.3%,65.0%,P=0.347),高于R组(53.3%,P=0.028),局部复发率RC组与RAD组近似(10.0%,18.3%,P=0.2944),低于R组(26.7%,P=0.0336);急性和后期放射反应RC组最重,RAD组最轻(P<0.05);RAD组生活质量最好(P<0.01)。结论放疗加艾迪注射液和放疗加同期化疗可以降低晚期鼻咽癌的局部复发率,提高生存率。

Objective To investigate the clinical effects, the therapy reactions,the living qualities of three treatments in advanced nasopharyngeal carcinoma. Methods From Jan 2001 to Jun 2002, 120 patients pathologically confirmed NPC who firstly underwent radiotherapy were divided into two groups： radiotherapy with concurrent chemotherapy group（RC, n = 60, 5 fractions per week, one time per day, 200 cGy per day to a total dose of 7 000 - 8 000 cGy. cisplatin and 5-Fu two cycles in the first and fourth week during radioation）; radiotherapy with AiDi injection group（RAD, n = 60, radiotherapy was the same as that of RC. Continuously injecting AiDi for 10 days 50 ml per day was one cycle which was repeated 3 cycles every alternation of 7 days）; another 60 patients who contemporaneity reciceved radiotherapy alone （radiotherapy was the same as that of RC） because of some reasons and were comparable in clilical materials were regarded as the third group （R） to compare with the above two groups. The life quality, 3-year survival rate, and acute or chronic radiation reactions in the three groups were observed. Results All patients were followed up for more than 3 years： the 3-year survival rate in RC （73.3%）,which was homologous as that in RAD（65.0 %, P =0.347）, was higher than that in R group（53.3%,P = 0.028）, and the local recurrent was inverse（10.0%,26.7%,P = 0.033 6）. The acute and chronic radiation reactions in RC was highest whereas that in RAD group is lowest （P 〈 0.05）, in which being the best living quality （P 〈 0.01）. Conclusions RAD and RC are feasiable in reducing the local recurrent rate and enhancing the surivial rate for patients in regionally-advanced nasopharyngeal carcinoma, furthermore, both exceed R.