后期同步放化疗治疗局部晚期下咽癌临床观察

Clinical study on late course concomitant radiochemotherapy for locally advanced hypopharynx cancer

目的:观察和比较后期同步放化疗治疗局部晚期下咽癌的近期疗效及不良反应。方法:首程经病理确诊44例局部晚期下咽癌患者,其中单纯放疗21例:2Gy/次,1次/天,5次/周,共35次,7周完成;后期同步放化疗23例,放疗方法同单纯放疗组,在放疗第4周开始化疗,予"FP"方案,3周为1周期,共2周期。结果:单纯放疗组和后期同步放化疗组的1、3年局部控制率分别为:47.6%、38.1%和82.6%、56.5%;1、3年生存率分别为:42.9%、28.6%和78.3%、47.8%;急性放射性黏膜反应的发生率均为100%。结论:后期同步放化疗组与单纯放疗组相比在不明显增加急性放射反应发生的情况下,具有提高肿瘤局控率和患者生存率的优势。

Objective：To observe the therapeutic effect and toxicity of late course concomitant radiochemotherapy for locally advanced hypopharynx cancer. Methods： Total of 44 patients with histologically conformed hypopharynx cancer were enrolled in the study ：21 patients in the single radiotherapy group treated by 2Gy/fraction per day ,5 treatment days per week, the total doses receieved were 70 Gy/35 fractions/49 days ;23 patients in the concomitant radiochemotherapy group received the same radiotherapy as the first group, a total of 4 cycles chemotherapy with FP regimen （ every 21 days） was delivered after 4 weeks of the course of radiotherapy. Results： The 1 - year and 3 - year locoregional control rates in the concomitant radiochemotherapy group and single radiochemotherapy group were47.6%, 38.1% and 82.6% ,56.5% repectively. The 1 - year and 3 - year survival rates were 42.9% ,28.6% and 78.3%, 47.8% repectively. The incidence rate of acute radioactive mucosa reaction in both groups were 100%. Conclusion： Compared with single radiochemotherapy, late course concomitant radiochemotherapy can improve the loeoregional control rate and survival rate of patients without significantly increasing acute side - effect.