同步放化疗对局部晚期鼻咽癌患者近远期预后的影响

Effect of concurrent chemoradiotherapy on short- or long-term prognosis of patients with locally advanced nasopharyngeal

目的:探讨多西他赛联合顺铂化疗同步调强适形放疗(intensity modulated radiation therapy,IMRT)对局部晚期鼻咽癌患者近远期预后的影响。方法:选取局部晚期鼻咽癌患者100例,按照随机数字表的方法将患者分为研究组和对照组,每组各50例。研究组给予IMRT,对照组给予常规放疗,在上述基础上两组均给予多西他赛联合顺铂化疗。观察两组鼻咽癌患者近远期预后情况。结果:完成放疗后3个月,研究组的临床治疗有效率高于对照组,差异有统计学意义(χ~2=12.000,P<0.05);研究组Ⅲ~Ⅳ口腔黏膜反应和Ⅲ~Ⅳ急性口感发生情况明显较对照组少,差异有统计学意义(χ~2=6.139,13.279;均P<0.05);两组患者远期疗效比较,研究组患者随访第2年局部区域控制和总生存情况与对照组比较差异具有统计学意义(χ~2=13.255,13.255;均P<0.05)。结论:多西他赛联合顺铂化疗同步IMRT对局部晚期鼻咽癌患者近远期临床效果满意,IMRT可以减少并发症的发生,有效保护人体正常组织。

Objective： To investigate the effect of docetaxel combined with cisplatin chemotherapy synchronized intensity modulation radiotherapy on the short-and long-term prognosis of patients with locally advanced nasopharyngeal carcinoma. Methods： One hundred patients with locally advanced nasopharyngeal carcinoma were randomly divided into a study group and a control group according to the random number table method. The study group were given intensity modulation radiotherapy, and the control group was given conventional radiotherapy. On the basis of the above, both groups were given docetaxel combined with cisplatin chemotherapy. The short-and long-term prognosis of the two groups were observed. Results： After 3 months of radiotherapy, the clinical treatment efficiency of the study group was higher than that of the control group, the difference was statistically significant（χ~2=12.000, P〈0.05）. The incidence of oral mucosal response and acute exacerbation of Ⅲ–Ⅳ in the study group was significantly lower than that in the control group（χ~2=6.139, 13.279; all P〈0.05）; the comparison of the long-term efficacy of the two groups showed that, the difference of local control and overall survival of follow-up for the second year between the two groups was statistically significant（χ~2=13.255, 13.255; all P〈0.05）. Conclusion： The short-and long-term clinical effects of docetaxel combined with cisplatin chemotherapy synchronized IMRT in patients were satisfied. IMRT can reduce the incidence of complications and protect the normal tissues of the human body effectively.