诱导化疗对局部晚期鼻咽癌放疗远期疗效的影响

Clinical analysis of chemotherapy plus radiotherapy in 120 cases of locally advanced nasopharyngeal carcinoma

目的:探讨诱导化疗对局部晚期鼻咽癌放疗远期疗效的影响。方法:回顾性分析120例Ⅲ、Ⅳa期鼻咽癌患者按治疗方法分为两组(化放组及单放组)。放疗采用直线加速器照射鼻咽及颈部,鼻咽剂量DT 70-76 Gy,7-7.5周,颈部剂量DT 50-70 Gy,5-7周。诱导化疗采用DDP+5-FU方案。结果:化放疗组1、3、5年生存率分别为98%、76%、20%;单放组分别为96%、60%、18%,无显著性差异(P>0.05)。化放组远处转移率为20.9%,单放组为41.7%,两组比较有显著性差异(P<0.05)。结论:诱导化疗能降低局部晚期鼻咽癌放疗的远处转移率,但没有提高生存率。

Objective： To study the influence of chemotherapy on the effect of radiotherapy in locally advanced nasopharyngeal carcinoma. Methods ：Total of 120 patients with histologically proven nasopharyngeal carcinoma in stages Ⅲ, Ⅳwere divided into two groups by the method of treatment. Radiotherapy group （65cases） only received radiotherapy with DT70 -76Gy in nasopharynx and DTS0 -70Gy in the neck. Chemoradiotherapy group （55cases） received chemotherapy with cisplatin and 5 - fluorouracil before the same radiotherapy as the radiotherapy only group. Results：The 1,3,5 -year survival rates were 98% ,76% ,20 % in chemoradiotherapy group and 96% ,60 % ,18 % in radiotherapy group respectively, with no significant difference between the two groups （P 〉 0.05 ）. Distant metastasis rates were 20.9 % in chemoradiotherapy group and 41.7 % in radiotherapy group respectively （ P 〈 0.05 ）. Conclusion：Chemotherapy plus radiotherapy can decrease the distant metastasis rate for locally advanced nasoharyngeal carcinoma,but can not increase the longterm survival rate.