同期放化疗治疗中晚期鼻咽癌的疗效观察

Clinical effect of concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma

目的观察同期放化疗治疗中晚期鼻咽癌的疗效。方法100例确诊为中晚期鼻咽癌患者随机分为同期放化疗组(A组)50例和单纯放疗组(B组)50例,A组在放射治疗的第1、4周给予2个周期顺铂加5氟尿嘧啶方案化疗;B组只给单纯放射治疗。结果A组完全缓解率84.0%(42/50)高于B组64.0%(32/50)(χ2=4.18,P<0.05);A组1、3年生存率分别为94.0%(47/50)、72.0%(36/50),高于B组88.0%(44/50)、54.0%(27/50)(χ2=0.80,P>0.05,χ2=4.75,P<0.05);A组局部复发率8.0%(4/50)明显低于B组26.0%(13/50)(χ2=3.85,P<0.05);A组3年远处转移率分别为14.0%(7/50)明显低于B组32.0%(16/50)(χ2=4.12,P<0.05)。A组黏膜损伤54.0%(27/50)明显高于B组29.4%(10/50)(χ2=4.38,P<0.05)。结论同期放化疗可以降低远处转移和提高3年生存率,其毒性反应可以耐受,值得在临床中推广。

Objective To evaluate the curative effect of radiotherapy combined with concurrent chemotherapy for the treatment of advanced nasopharyngeal carcinoma. Methods 100 cases with advanced nasopharyngeal carcinoma（ stage Ⅲ and Ⅳa）were randomized into 2 groups. Group A received radiotherapy with concurrent chemotherapy （n = 50 ）and Group B received radiotherapy alone（ n = 50 ）. A group of radia-tion therapy in the 1,4 weeks to give 2 cycles of cisplatin plus 5-fluorouraeil chemotherapy;B group only to radiation therapy alone. Results The rate of complete remission were 84.0% （42/50） in A group higher than the 64. 0% （32/ 50）in B group（x^2 =4. 18,P 〈0. 05） ;The rates of 1,3-year survival were 94.0% （47/50） ,72.0% （36/50）in A group higher than the 88. 0% （44/50）, 54.0% （27/50） in B group（x^2 =0. 80,x^2 =2.75, P 〈0. 05） ; The rate of local recurrence were 8.0 percent （4/50） in A group were significantly lower than 26.0% （ 13/50 ） in B grouP（X^2 = 3.85 ,P 〈 0. 05 ） ;The rate of distant metastasis of 3-year were 14. 0% （7/50） in A Group were significantly lower than 32. 0% （16/50）in B Group（x^2 =4. 12,P 〈0.05） ;the mueosal injury were 54. 0% （27/ 50） in A group were significantly higher than 29.4% （10/50）in B group（x^2 = 4. 38 ,P 〈 0. 05 ）. Conclusion Radiotherapy with concurrent chemotherapy can improve the 3-year survival rate and decrease the distant metastasis rate in patients with advanced nasopharyngeal carcinoma.