PF方案化放治疗晚期鼻咽癌的远期疗效

The long term therapeutic results of chemotherapy combined with radiotherapy in advanced nasopharyngeal carcinoma

目的探索用ＰＤＤ／５－Ｆｕ方案化放治疗晚期鼻咽癌的疗效。方法１９８９年１２月～１９９０年１２月间，选择７６例Ⅲ、Ⅳ期鼻咽癌患者，先作３周期ＰＤＤ（２０ｍｇ（ｍ２）－１ｄ－１，ｉｖ，第１～５天）和５－Ｆｕ［７００ｍｇ（ｍ２）－１ｄ－１，连续静脉滴注，第１～５天］诱导化疗，随后尽快作放疗，此为综合治疗组。以１９８９年作单纯放疗的８６例晚期鼻咽癌患者作对照组。两组放疗方法、时间／剂量分割均相同。结果化疗有效率为８９．３％，完全缓解率为１８．４％。综合治疗组（综合组）总的５年生存率为４８．７％，对照组为３３．７％（Ｐ＞０．０５）。综合组Ｔ２Ｎ３和Ｔ２～４Ｎ３患者的５年生存率为４４．１％和３９．５％，均明显高于对照组的２１．６％及２０．４％（Ｐ＜０．０５）。结论ＰＦ方案化放治疗提高了Ｔ２～４Ｎ３患者的５年生存率。

Objective To evaluate the effect of chemothrapy combined with radiotherapy in advanced nasopharyngeal carcinoma (NPC).Methods From Dec. 1989 to Dec. 1990, 76 patients with locally advanced NPC (stage Ⅲ or Ⅳ) were treated with 3 cycles of cisplatin [PDD, 20 mg·(m 2) -1 ·day -1 , iv on days 1～5] and 5 Fluorouracil (5 Fu, 700 mg·(m 2) -1 ·day -1 by continuous iv infusion on days 1～5 followed shortly thereafter by radiotherapy. Eighty six patients treated with radiotherapy alone in 1989 were taken as control. The methods and time/dose schedule of radiotherapy were similar in the two groups.Results The response rate to chemotherapy was 89.3% [complete response (CR) 18.4%]. The overall 5 year survival was 48.7% in the combined treatment group and 33.6% in the control group ( P >0.05). The 5 year survival in the combined treatment group was 44.1% and 39.5%, in patients with T 2N 3 and T 2～4 N 3 and 21.6% and 20.4% in the control group, respectively ( P <0.05). Conclusion This prospective study demonstrates that PDD/5 Fu chemotherapy followed by radiotherapy can improve 5 year survival in patients with T 2～4 N 3 nasopharyngeal carcinoma,