同步放化疗联合辅助化疗治疗局部晚期鼻咽癌临床研究

A clinical study of concurrent radio-chemotherapy combineel with adjuvant chemotherapy in treatment of locally advanced nasopharyngeal carcinoma

目的:探讨紫杉醇加顺铂(TP)同步放化疗联合辅助化疗治疗局部晚期鼻咽癌的疗效及毒副反应。方法:82例病理证实局部晚期(Ⅲ期和ⅠVa期)鼻咽癌患者,随机分为同步放化疗联合辅助化疗组(44例),单纯放疗组(38例)。两组均采用4MV或者8MV-X线常规放疗,鼻咽部总剂量68～74Gy,同步放化疗联合辅助化疗组同时给予紫杉醇135mg/m2,d1+DDP 25mg/m2,d1-d3于治疗的第1周、第6周静滴,治疗结束休息2周,再予同方案化疗2周期,21 d为1周期。结果:治疗结束时及治疗结束后3月,单纯放疗组和同步放化疗联合辅助化疗组,有效率分别为71.1%、76.3%和88.6%、95.5%,差异有统计学意义(P【0.05),两组1年、2年生存率分别为81.1%、73%和95.2%、90.5%,差异有统计学意义(P【0.05)。同步放化疗联合辅助化疗组的Ⅰ、Ⅱ度、消化道及皮肤、口腔粘膜反应高于单纯放疗组(P【0.05)。Ⅲ、Ⅳ度反应及其它急性毒副反应,晚期放射性损伤两组间差异无统计学意义。结论:同步放化疗联合辅助化疗可提高局部晚期鼻咽癌的近期疗效和总生存率,但毒副反应有增加的趋势。

Objective:To investigate the paclitaxel plus cisplatin(TP) Concurrent chemotherapy combined with adjuvant chemotherapy for the treatment of locally advanced nasopharyn-geal cancer efficacy and toxicity.Methods: 82 cases of pathologi-cally confirmed locally advanced(III and IVa period period) in patients with nasopharyngeal carcinoma,radiotherapy and chemo-therapy were randomly divided into synchronous joint-adjuvant chemotherapy group(44 cases),radiotherapy alone group(38 cases).4MV two are 8MV-X-ray or conventional radiotherapy,total dose of the nasopharyngeal 68-74Gy,Concurrent chemother-apy combined with adjuvant chemotherapy group given paclitaxel 135mg/m2,d1+DDP 25mg/m2,d1-d3 to treat the first 1 week,the first intravenous infusion of 6 weeks,the treatment of the end of two weeks to rest,re-chemotherapy with 2 cycles,1 cycle of 21days.Results: The end of treatment and treatment after the end of March,radiotherapy alone group and combined radiotherapy and chemotherapy simultaneously adjuvant chemotherapy group,there were 71.1% efficiency,76.3% and 88.6%,95.5%,the difference was statistically significant(P<0.05),One year,two-year survival rates were 81.1%,73% and 95.2%,90.5%,the difference was sig-nificant(P<0.05).Concurrent chemotherapy combined with adju-vant chemotherapy group Ⅰ、 Ⅱ,the digestive tract and skin and oral mucosa reactions than radiotherapy alone group(P<0.05).Ⅲ,Ⅳ degree of reaction and other side effects of acute and late radia-tion injury between the two groups the difference was not statisti-cally significant.Conclusion: Concurrent chemotherapy combined with adjuvant chemotherapy for locally advanced nasopharyngeal cancer can increase the short-term efficacy and overall survival,but toxicity increase.