阿霉素、顺铂与外照射联合应用治疗晚期鼻咽癌的远期疗效分析

AN ANALYSIS OF LONG -TERM RESULTS AFTER COMBINED TREATMENT OF ADM DDP AND IRRADIATION FOR ADVANCED NASOPHARYNGEAL CARCINOMA

本文报告用ADM、DDP与外照射联合治疗晚期鼻咽癌60例,随机分为A—P组与DDP组各30例。ADM、及DDP剂量均按50mg/m^2计算,A—P组同时用ADM和DDP两药,DDP组仅用单药。化疗结束后近期疗效评定有效率为:A—P组53.33％稍优于DDP组20.0％;加行常规分段外照射鼻咽组织量达60～80Gy后,两组的癌灶消失、残留及恶化病例数相等,综合治疗后近期疗效相同。经7年以上随诊,5年生存率41.67％(25/60),其中A—P组36.67％,DDP组46.67％;Ⅲ期46.81％(22/47),Ⅳ期23.08％(3/13);7年生存率为33.33％(20/60),两组各10例,Ⅲ期36.17％(17/47),Ⅳ期23.08％。提示ADM、DDP与外照射联合治疗晚期鼻咽癌,未能显示其协同抗癌作用,其治疗方式仍有待进一步的探讨。

60 cases of advanced NPC were treated with ADM, DDP and irradiation . It is randomly divided into A-P group and DDP group prior to irradiation. The dose of ADM nd DDP was 50mg/ m 2 . ADM and DDP were used in A-P group, and DDP was used alone in DDP group. The current response rate in A-P group was 53.33% and better than that of DDP group 20.0%, After ckemotherapy, 60-80Gy were given to all the patients by split dose technique, the frequence of subsidence of the primary lesion, residue and deterioration were fairly similar in both groups. With a follow-up over 7-years, the total 5-year survival rate was 41.67%( 25/ 60) in both groups, and ft was 46.81 % ( 22/ 47) in stage m, 23.08 % ( 3 / 13) in stage Ⅳ. While it was 36.67 % in A-P group, 46.67%( 14/ 30) in DDP group. The average 7-year survival rate Was 33.33% ( 20/ 60), it was of 10 cases in each group, the survival rate in stage Ⅲ and Ⅳ was 36.17%(17/ 47) and 23.08%(3/ 13) . These results indicated that above-mentioned reginencould not improve the prognosis for advanced NPC as compare with the irradiation alone, and further studies are needed.