同步放化疗治疗中晚期鼻咽癌的近期疗效及增加放疗副反应的观察

Clinical study on concurrent chemoradiotherapy and radiotherapy alone for advanced nasopharygeal carcinoma

目的观察同步放化疗治疗中晚期鼻咽癌的近期疗效及化疗对放疗副反应的影响。方法52例初治中晚期鼻咽癌患者按住院时间顺序非双盲法分为同步放化组及单放组各26例，两组放疗方法及剂量相同（鼻咽部70-74Gy，颈部淋巴结转移根治量64～70Gy，颈部预防量50～54Gy），同步放化组另在放疗开始前、中、后，采用顺铂＋5。Fu＋亚叶酸钙化疗4周期，21天／周期。结果放疗结束时及治疗结束后3个月，同步放化组的鼻咽原发灶及颈部淋巴结完全缓解率均比单放组高（P〈0．05），但出现口腔溃疡、咽喉疼痛及需暂停放疗的发生率均比单放组高（P〈0．05）。结论同步放化疗可明显提高晚期鼻咽癌原发病灶及颈部淋巴结转移病灶的消退率，但可加重放疗的不良反应。

Objective Nasopharyngeal carcinoma（ NPC） is a radiosensitive and chemosensitive tumor. The main ot rite present study is to evaluate the efficacy and toxicity of concurrent chemoradiotherapy for advanced NPC. Methods 52 NPC cases were randomly allocated into two groups. Similar dosage and fractionation of radiotherapy was administered in both groups. The investigational group （ 26 cases） received four cysles of concurrent chemotherapy with Cisplatin plus Tegafur plus Leucovorin at the early,middle and last stage during radiotherapy （21 days as one cycle）. Results The complete response rate of primary tumor and neck nodes in the investigational group was significantly higher than in the radiotherapy alone group,P 〈 0. 05,Conclusions The method of concurrent chemoradiotherapy is an effective and well-tolerated regimen for the treatment of locally advanced NPC, although toxicity may occur during radiotherapy.