同步放化疗治疗局部晚期鼻咽癌合并糖尿病临床观察

Chemoradiotherapy for advanced nasopharyngeal carcinoma complicated with diabetes mellitus

目的调查分析局部晚期鼻咽癌并糖尿病患者行同步放化疗的安全性及耐受性。方法回顾性分析15例行同步放化疗鼻咽癌合并糖尿病住院患者的皮肤、黏膜及血液学毒性反应，血糖检测情况和医院感染情况及随访结果。结果14例患者完成2个周期同步化学疗法（化疗），1例患者因医院感染及食欲严重减退同步化疗仅行1周期化疗；放化疗结束后3～4周有9例患者行2个周期巩固化疗。放化疗期间有3例患者并医院感染，其中2例患者为真菌与细菌}昆合感染。中位随访期为10个月，12例患者无瘤生存；有3例患者死亡，其中2例死于局部未控鼻咽大出血、1例于放化疗开始后7个月死于全身多发骨转移骨髓浸润。结论局部晚期鼻咽癌并糖尿病患者行同步放化疗治疗，毒性反应可耐受。

Objective To investigate the safety and tolerability of nosocomial infection in patients with advanced nasopharyngeal cancer complicated with diabetes mellitus during chemoradiotherapy. Methods The skin, mucous membranes and hematological toxicity, the situation of blood glucose monitoring and hospital infection and follow-up results of 15 cases of nasopharyngeal carcinoma combined chemoradiotherapy in hospitalized patients with diabetes were retrospectively analyzed. Results There were 14 cases completed 2 cycles concurrent ehemtherapy, 1 case completed only one cycle concurrent chemotherapy because of hospital infection and severe loss of appetite. Nine patients received 2 cycles of chemotherapy to consolidate 3-4 weeks after chemoradiotherapy. During chemoradiotherapy, 3 eases had been hospital infection, including 2 patients with mixed fungal and bacterial infections. Median follow-up period of the patients was 10 months, 12 patients were tumor-free survival;three patients died ,2 patients died of uncontrolled local nasopharyngeal bleeding, 1 patient died of whole body bone marrow infiltration and multiple bone metastasis 7 months after chemoradiotherapy. Conclusion Side effects of chemoradiotherapy treatment of locally advanced nasopharyngeal carcinoma complicated with diabetes mellitus can be tolerated in patients.