介入联合同期放化疗治疗局部晚期鼻咽癌的临床研究

A Clinical Trial of Transcatheter Superselective Intra-arterial Chemotherapy Combined with Concurrent Chemoradiotherapy in the Treatment for Advanced Nasopharyngeal Carcinoma

[目的]探讨介入联合同期放化疗治疗局部晚期鼻咽癌的疗效。[方法]收集108例初治局部晚期鼻咽癌患者(Ⅲ～Ⅳa期),分为介入联合同期放化疗组(研究组)以及同期放化疗组(对照组)。观察并比较两组的近、远期疗效和不良反应。[结果]研究组与对照组的治疗总有效率分别为92.7%和79.2%,差异有统计学意义(P=0.04)。研究组3年生存率为98.2%,对照组为96.2%;3年复发率分别为9.1%与17.0%,远处转移率分别为5.5%与13.2%,差异均无统计学意义(P>0.05)。两组急性不良反应比较亦无显著性差异。[结论]介入联合同期放化疗治疗局部晚期鼻咽癌,对比同期放化疗,近期疗效有所提高,急性不良反应相似。

[Purpose] To investigate the effect of transcatheter superselective intra-arterial chemotherapy combined with concurrent chemoradiotherapy in the treatment for advanced nasopharyngeal carcinoma.[Methods] A total of 108 patients with advanced nasopharyngeal carcinoma（stage Ⅲ-Ⅳa） were enrolled in this study,and were divided into transcatheter superselective intra-arterial chemotherapy combined with concurrent chemoradiotherapy group（research group） and concurrent chemoradiotherapy group（control group）.The clinical efficacy and side effects were observed and compared between the two groups.[Results] The response rates of research group and control group were 92.7% and 79.2%,respectively,with significant difference（P=0.04）.The 3-year survival rates of research group and control group were 98.2% and 96.2%;3-year local recurrent rates were 9.1% and 17.0%;the distant metastasis rates were 5.5% and 13.2%.None of them had significant difference between two groups.The degree of acute toxicity between two groups was similar,also without significant difference.[Conclusion] Compared with concurrent chemoradiotherapy alone,the selective arterial chemotherapy combined with concurrent chemoradiotherapy is benefit in short-term response in the treatment for advanced nasopharyngeal carcinoma,but the acute toxicity is similar between the two groups.