放-热-化疗三联治疗鼻咽癌巨大颈部转移灶近期疗效观察

Immediate response of patients with big metastatic cervical lesions of nasopharyngeal carcinoma treated by radio-thermo chemotherapy (RTCH)

本研究目的是评价放－热－化（ＲＴＣＨ）三联治疗鼻咽癌颈部巨大转移灶的疗效。１３例有颈部巨大转移灶中，１０例有双侧颈部淋巴结转移。作为自身对照观察，在一侧最大径７ｃｍ以上的１０个病灶接受ＲＴＣＨ治疗，而对侧较小的１０个病灶接受ＲＴＨ治疗。另３例单侧颈部淋巴结转移且直径７ｃｍ以上的患者也接受ＲＴＨ治疗。结果显示接受ＲＴＣＨ的１３个病灶的ＣＲ率为７７％（１０／１３），较报道的ＲＴＨ的ＣＲ率５３％高。而自身对照的病灶，ＲＴＣＨ和ＲＴＨ的ＣＲ率分别为７０％（７／１０）和５０％（５／１０）。治疗过程中除化疗药物引起的一般毒副反应外，无严重毒副反应。初步研究结果提示，ＲＴＣＨ能提高鼻咽癌颈部巨大转移灶的局部控制率。

Objective: To evaluate immediate reponse of patients with big metastatic cervical lesions of nasopharyngeal carcinoma (NPC) treated by RTCHIn 13 lesions with big metastatic cervical lesions,there were 10 patients with bilateral nodesFor self-control observation,10 nodes larger than 7cm in diameter on one side neck recieved RTCH,and 10 ones on opposite lateral were smaller,they were treated by RTHOther three patients with unilateral nodes which were larger than 7cm in diameter recieved RTCH tooThe results showed that CR rate in 13 lesions with nodes larger than 7cm in diameter was 77% (10/13)for RTCH,it was better than RTH in literatures reported (53%)Concerning self-control,CR rate was 70%(7/10)for RTCH,and 50% (5/10) for RTHExcept that common toxic effects were caused by chemotherapy agents,severe toxic response was not seen during the courseThe preliminary results may imply that RTCH could enhance the local control rate of big metastatic cervical lesions of NPC and the RTCH regime is safe \ \