同步放化疗综合治疗中晚期鼻咽癌的疗效观察

A Clinical Study of Response of Concurrent Radio-Chemotherapy in Cases with Advanced Nasopharyngeal Carcinoma

目的探讨同步放化疗综合治疗中晚期鼻咽癌的临床疗效。方法1998-2006年我科收治的中晚期鼻～咽癌64例，原发灶放疗方案为双侧面颈联合野常规分割放疗40Gy后局部光子刀加量，DT量至70～76Gy／5～7周。颈部淋巴结行常规分割放疗后局部加量。同步化疗应用DF方案，放疗的前、中、后期各行1周期化疗，每周期间隔21d。观察综合治疗的疗效和患者的耐受性。结果原发灶1、6、12个月的完全缓解率为87．5％、90．6％、93．7％，颈部淋巴结完全缓解率分别为92．1％、95．3％、98.4％，1、3、5年总生存率为91．5％、80．4％、62．5％。毒副反应早期主要为骨髓抑制，胃肠道反应和口腔黏膜炎；晚期则主要为口干和颈部纤维化，患者可耐受。结论同步放化疗临床疗效好，毒副反应患者可耐受，有较高的临床推广应用价值。

Objective To study clinical response of concurrent radio-chemotherapy for advanced nasopharyngeal carcinoma. Methods There were 64 eases with nasopharyngeal carcinoma compiled in radiotherapy department from 1998 to 2006. Primary tumor in radiotherapy program was treated in two sides of surface-neck associated with campus conventional fraetionated radiotherapy （ DT 40 Gy） before X-Knife radiosurgery,aeeumulated doses reached 70-76 Gy/5-7 week. Neck nodes were treated by conventional fraetionated radiotherapy. DF chemotherapy program was Utilized in those eases. Three chemotherapy programs were administered in the preceding,middle and last period of conventional fraetionated radiotherapy and concurrent radio-chemotherapy,while there were 21 days in each cycle. Results The complete response rates for 1, 6, 12 months after the completion of RT were 87.5% ,90.6% ,93.7% respectively for primary focuses;92.1% ,95.3% and 98.4 % respectively for neck nodes ; the overall survival rates were 91.5 % , 80.4 % ,62.5 % for 1,3,5 years ; early common toxieities ineluded Ⅱ -Ⅲ grade neutropenia and mueositis and late injuries were main oral dryness and neck skin fibrosis. Conclusions The results of concurrent radio-chemotherapy for advanced nasopharyngeal carcinoma were eneouraging;toxieities and side reaction were slight;all patients can tolerate them.