多西他赛联合顺铂方案治疗局部晚期鼻咽癌的疗效和预后分析

Therapeutic Efficacy and Prognosis of Chemotherapy of Docetaxel and Cisplatin Combined with Radiotherapy for Local Advanced Nasopharyngeal Carcinoma

目的:分析多西他赛(TXT)+顺铂(DDP)方案联合放疗治疗局部晚期鼻咽癌的疗效和预后情况。方法:选择2003年1月-2006年12月收治的初治局部晚期鼻咽癌患者59例,观察TXT+DDP联合放疗治疗局部晚期鼻咽癌的疗效、预后及其影响因素,计算生存率及局部控制率。结果:59例患者,5年生存率、无复发生存率、无转移生存率分别为72%、82%和54%。与总生存率有关的因素有T分期、N分期、92福州分期、年龄、治疗前贫血、KPS评分,与无复发生存率有关的因素有T分期、贫血、KPS评分。结论:TXT+DDP诱导化疗及同期放/化疗加辅助化疗治疗局部晚期鼻咽癌,远期生存率好,5年无复发生存率及5年无远转生存率有较大的提高且毒副反应轻。早期发现患者,治疗前改善一般状况及纠正贫血有助提高生存率。

OBJECTIVE： To analyze the therapeutic efficacy and prognosis of chemotherapy of docetaxel（TXT） and cisplatin （DDP） combined with radiotherapy for local advanced nasopharyngeal carcinoma （NPC）. METHODS： From Jan. 2003 to Dec. 2006, 59 newly diagnosed patients with local advanced NPC were treated with chemotherapy of TXT＋DDP combined radiotherapy. The therapeutic efficacy, prognosis and influencing factors were observed. Survival rate and local control rate were calculated using Kaplan-Meier method, and the difference test was conducted by Cox proportion risk model. RESULTS： The 5-year overall survival rate and relapse-free survival rate and metastasis-free survival rate were 72%, 82% and 54%, respectively. T stage and N stage, 92 Fuzhou stage, age, pretreatment hemoglobin level, KPS score were all associated with overall survival rate. T stage, pretreat- ment hemoglobin level and KPS score were related to relapse-free survival rate. CONCLUSION： The chemotherapy of TXT＋DDP combined with radiotherapy in the treatment of local advanced NPC are promised. Long-term survival rate, 5-year relapse-free sur- vival rate and metastasis-free survival rate have been improved significantly. There are mild toxic reactions. Early diagnosis and treatment, pretreatment relief and anaemia correction can improve survival rate significantly.