高聚生配合外照射治疗鼻咽癌的临床研究

Clinical Study on Nasopharyngeal Carcinoma Treated with Radiotherapy Combined with BM828

目的：观察高聚生配合外照射治疗鼻咽癌的疗效。方法：160例鼻咽癌随机分入放疗加高聚生组(A组）和单纯放疗组(B组）。A组高聚生用法：放疗前3～5天开始用1 000U，肌注，每天1次，直至放疗结束。B组单纯放射治疗，每天2Gy，每周5次。两组放疗方法、剂量相同。结果：放疗后3个月检查 A、B两组鼻咽部肿瘤完全消退率分别为88．7％和81．3％(P＞0．05）。颈部转移淋巴结完全消退率分别为86．3％和73．6％(P＞0．05）。3年生存率A、B组分别为76．3％和66．3％(P＞0．05），5年生存率A、B组分别为65．0％和52．5％(P＞0．05）；3年鼻咽部肿瘤控制率A、B组分别为76．3％和68．8％(P＞0．05），5年鼻咽部肿瘤控制率A、B组分别为71．3％和58．8％(P＞0．05）；3年颈淋巴结转移灶控制率A、B组分别为72．6％和62．5％(P＞0．05），5年颈淋巴结转移灶控制率A、B组分别为61．6％和48．6％(P＞0．05）。5年远处转移发生率A、B组分别为28．8％和42．5％(P＜0．05）。A组急性毒副反应与B组相似。结论：高聚生配合外照射治疗鼻咽癌无明显提高患者的生存率和局部控制率，但有助于降低远处转移的发生。

Objective： To evaluate the efficacy of radiotherapy combined with BM828 for nasopharyngeal carcinoma (NPC)． Methods： From April 1992 to August 1994， 160 cases of NPC (stage Ⅱ－Ⅳ) were randomized to receive radiotherapy combined with BM828 (group A) and radiotherapy alone (group B)． These two groups were treated with the same dosage of radiotherapy． Results： The 3－year survival rates of group A and group B were 76．3％， 63．3％ and 5－year survival rates of these two groups were 65．0％ ，52．5％ (P＞0．05) respectively． The 3－year primary lesion control rates of group A and group B were 76．3％， 68．8％ (P＞0．05) and 5－year primary lesion control rates of these two groups were 71．3％， 58．8％ (P＞0．05) respectively． The 3－year cervical node control rates of group A and group B were 72．6％， 62．5％ (P＞0．05) and 5－year cervical node control rates were 61．6％， 48．6％ (P＞0．05) respectively． But the distant metastatic rate of group A was lower than that of group B (28．8％ vs 42．5％， P＜0．05)． Conclusion： BM828 plus radiotherapy may not increase the survival rate and local lesion control rate of NPC， but it may lower the distant metastases in patients with NPC．