晚期鼻咽癌同步放化疗前瞻性随机观察

Prospective and Randomized Study of Synchronous Radiotherapy and Chemother apy for Advanced Nasopharyngeal Carcinoma

目的:观察晚期鼻咽癌同步放、化疗近期疗效及急性不良反应。方法:80例晚期鼻咽癌患者,随机分为同步放、化疗组(观察组)和单纯放疗组,进行近期疗效及不良反应对比。两组放疗方法相同。观察组于放疗同时给予DDP、5-FU和Pingyangmycin化疗。结果:观察组局部肿瘤消退时放疗剂量显著低于单纯放疗组(P<0.05);放疗结束时CR评价,观察组较单纯放疗组高,但无统计学差异。放疗结束6个月时评价有显著性差异(P=0.002)。急性不良反应中,观察组的胃肠反应增加(P=0.02),但尚可接受。对白细胞和咽粘膜的不良反应增加不明显。结论:同步放、化疗可提高晚期鼻咽癌近期局部控制率,急性不良反应尚可接受。

Objecti ve :To observe the short-term curative effects and the acute adverse ef-fects of synchronous radiotherapy and chemotherapy for advanced nasopharyngeal carcinoma .Methods:Eighty patients with advanced nasopharyngeal carcinoma were randomiz ed into syn-chronous radiotherapy and chemotherapy group(observed group)and m ere radiotherapy group.The short-term curative effects and the adverse effects in these two groups were compared.Ra-diotherapy in both groups was performed with the same method,only in the observed group cis-platin,fluorouracil and pingyangmycin were given additionally.Results:The radiation dosage for remiss ion of local tumor was much lower in the observed group than that in the mere ra diothera-py group(P<0.05).The CR rate was higher in the observed group than that in the mere radio-therapy group when evaluated after completion of ra diotherapy;the difference was not statistically significant but was remarkabl e after six months(P=0.002).The rate of gastrointestinal adverse ef-fe cts increased in the observed group(P=0.02),but the patients were able to endure.The rate of adverse effects associated with leucocytes and pharyngeal mucosa did not increase significantly.Conclusion:The short-term local contro l rate of advanced nasopharyngeal carcinoma may be im-porved by synchronous ra diotherapy and chemotherapy,and the patients can endure the acute ad-verse eff ects caused by this treatment.