局部晚期鼻咽癌同步时辰放、化疗的近期疗效观察

Short-term observation on the clinical outcome of concurrent chemoradiotherapy for nasopharyngeal carcinoma

目的：观察局部晚期鼻咽癌同步时辰放、化疗及后程三维适形放疗的肿瘤局部控制率和不良反应的发生情况。方法：2005年8月-2007年8月共纳入67例局部晚期鼻咽癌患者（Ⅲ～ⅣA），常规放疗40Gy后行鼻咽病灶后程三维适形放疗30Gy。整个放疗过程中同步时辰给予顺铂、氟尿嘧啶和亚叶酸钙化疗，观察患者的近期疗效和不良反应。结果：1例患者因发生Ⅳ级口腔黏膜炎而放弃同步放、化疗。放疗结束后3个月内，66例患者中无一例发生放疗野内的肿瘤复发，其中鼻咽部肿瘤和颈部病灶达完全缓解者49例（74．2％），部分缓解15例（22．7％），疾病稳定2例（3．0％），无一例患者发生疾病进展。治疗有效率达97．0％。不良反应均可耐受。结论：同步时辰放、化疗及后程三维适形放疗治疗局部晚期鼻咽癌的近期疗效令人满意，且不良反应基本可以耐受。

Objective： To observe the local control rate and the adverse reaction of concurrent chemoradiotherapy with the latecourse three dimensional conformal radiotherapy for advanced nasopharyngeal carcinoma. Methods： Sixty-seven patients with advanced nasopharyngeal carcinoma （Ⅲ-ⅣA） were recruited in this study from August 2005 to August 2007. They received conventional radio- therapy at 40 Gy followed by three dimensional conformal radiotherapy at 30 Gy. Chemotherapy （ cisplatin ＋ 5-FU ＋ calcium folinate ） was given to the patients concurrently. The short-term efficacy and adverse reaction were observed. Results： One patient did not com- plete the concurrent radiochemotherapy for Ⅳ grade oral mucositis. No relapse was observed in the radiation field of the rest of 66 cases during the 3 months after radiotherapy. Complete response was observed at the nasopharyngeal and jugular focus in 49 cases （74.2%）, partial response was observed in 15 cases （22.7%） , and stable disease was observed in 2 cases （3.0%）. No patients had progressed disease. The response rate was 97.0%. The adverse reaction was tolerable. Conclusion ： Concurrent chemoradiotherapy with the late- course three dimensional conformal radiotherapy has satisfying efficacy in the treatment of advanced nasopharyngeal carcinoma and the adverse reaction is tolerable.