中晚期鼻咽癌同步放化疗的近期疗效观察(附45例报告)

Clinical Study on Concurrent Chemoradiotherapy and Radiotherapy alone for Advanced Nasopharygeal Carcinoma

目的观察中晚期鼻咽癌同步放化疗的近期疗效及化疗对放疗副反应的影响。方法91例初治中晚期鼻咽癌患者随机分为同步放化组(45例)及单放组(46例);2组的放疗方法及剂量相同(鼻咽部70～78Gy,颈部淋巴结转移者根治量64～70Gy,颈部预防量50～54Gy);同步放化组另采用顺铂、亚叶酸钙及替加氟化疗4周期(分别在放疗前、中、后,21天/周期)。结果放疗结束时及治疗结束后3个月,同步放化组的鼻咽原发灶及颈部的肿瘤完全消退率均比单放组高(<0.05)。同步放化组出现口腔溃疡、咽喉疼痛、伴吞咽困难及需暂停放疗的发生率比单放组高(<0.05)。结论同步放化疗可明显提高晚期鼻咽癌原发病灶及颈部淋巴结转移病灶的消退率,但亦加重放疗的副反应。

Objective Nasopharyngeal carcinoma（NPC） is a radiosensitive and chemosensitive tumor. The main aim of the present study is to evaluate the efficacy and toxicity of concurrent chemoradiotherapy for advanced NPC. Methods From March 2004 to March 2005, 91 NPC cases were randomly allocated into two groups. Similar dosage and fractionation of radiotherapy was administered in both groups. The investigational group （45 cases） received four cycles of concurrent chemotherapy with Cisplatin plus Tegafur plus Leucovorin at the early, middle and last stage during radiotherapy（21 days as one cycle）. Results The complete response rate of primary tumor and neck nodes in the investigational group was significantly higher than in the radiotherapy alone group, P〈0.05. The toxicity rate of radiotherapy in the investigational group was significantly higher than in the radiotherapy alone group, P〈0.05. Conclusion The method of concurrent chemoradiotherapy is an effective and well-tolerated regimen for the treatment of locally advanced NPC, although toxicity may occur during radiotherapy.