紫杉醇+顺铂化疗联合调强放疗治疗鼻咽癌的临床观察

Clinical Study of Taxol and Cisplatin Chemotherapy Combined with Intensity Modulated Radiation Therapy in the Treatment of Nasopharyngeal Carcinoma

目的探讨紫杉醇+顺铂化疗联合调强放疗治疗鼻咽癌的临床疗效。方法收集鼻咽癌患者共110例,其中单纯调强放疗48例为对照组,紫杉醇+顺铂化疗联合调强放疗62例为观察组。比较2组近期疗效、不良反应、随访生存及复发情况。结果观察组近期有效率为93.55%,显著高于对照组的79.17%,差异有统计学意义(P<0.05)。不良反应方面,2组血小板减少、白细胞减少发生率比较,差异有统计学意义(P<0.05);但2组3~4级血小板减少、白细胞减少发生率比较,无统计学差异(P>0.05)。观察组随访3年总生存率、无瘤生存率分别为85.48%、83.87%,显著高于对照组的68.75%、66.67%,差异有统计学意义(P<0.05);复发及远处转移方面,2组差异无统计学意义(P>0.05)。结论相比单纯调强放疗治疗,紫杉醇+顺铂化疗联合调强放疗治疗鼻咽癌近期疗效更好,能显著提高患者3年总生存率及无瘤生存率,且局部复发及远处转移率相对较低。

Objective To investigate tile clinical effect of taxol and cisplatin chemotherapy combined with intensity mod- ulated radiation therapy in the treatment of nasopharyngeal carcinoma. Methods A total of 110 patients witil nasopharyngeal car- cinoma were studied. 48 cases treated by simple intensity modulated radiation therapy were the control group, and 62 cases treated by taxol and cisplatin chemotherapy combined with intensity modulated radiation therapy were the observation group. The short- term curative effect, side effects, follow-up survival and recurrence were compared between the 2 groups. Results The shorHerm effective rate in the observation group（93.55% ） was significantly higher than that in control group（93.55% ） （ P 〈 0.05 ）. In terms of side effects, the differences in the incidence rates of thrombocytopenia and leukopenia between the 2 groups were signifi- cant （ P 〈 0.05 ）. However, there was no significant difference in 3 - 4 level thrombocytopenia and leukopenia （ P 〉 0.05 ）. The 3- year overall survival rate and tumor-free survival rate of observation group （85.48% , 83.87% ） were significantly higher than those of the control group（68.75% ,66.67% ） （P 〈0.05 ）. There were no significant differences in recurrence and distant metas- tasis between the 2 groups （P 〉 0.05 ）. Conclusion Compared with simple intensity modulated radiation therapy, the short-term effect of taxol and cisplatin chemotherapy combined with intensity modulated radiation therapy in the treatment of nasopharyngeal carcinoma is better. It can significantly improve the 3-year overall survival rate and tumor-free survival rate. The rates of local rc- currence and distant metastasis are relatively lower.