Ⅲ Ⅳa期鼻咽癌放疗前诱导化疗的前瞻性观察

Clinical Observation on Advanced NPC of Induction Chemotherapy

探讨用THP、DDP、5-FU方案在Ⅲ、Ⅳa期鼻咽癌放疗前诱导化疗1周期的疗效。方法:1996年12月～1998年6月收治了82例Ⅲ、Ⅳa期鼻咽部低分化鳞癌患者,按来院治疗时间分为A组(综合治疗组)42例和B组(单纯放疗组)40例。A组采用THP(吡柔比星)50mg/m2·d;DDP(顺铂)80mg/m2·d,和5-FU(5-氟脲嘧啶)200mg/m2·d,连续5天静脉点滴。诱导化疗结束后第3天开始放疗。结果:A组和B组患者鼻咽肿块控制率分别为88.0%、67.5%(P<0.05);颈部肿块控制率分别为87.0%、42.9%(P<0.01);A组和B组CR率分别为90.4%、52.5%(P<0.01);5年生存率为50.0%、27.5%(P<0.05)。结论:THP、DDP、5-FU方案诱导化疗1周期能提高患者的局部控制率,改善近期疗效,同时提高患者的5年生存率。

Objective: By THP﹒DDP﹒5-Fuscheme, the paper tries to explore before the curative effect of one-cycle induction chemotherapy the radiotherapy in Ⅲ Ⅳa nasopharyngeal carcinoma (NPC). Methods: From Ded · 1996 to June · 1998, 82 patients with locally Ⅲ Ⅳa NPC were accepted by Nan Hua Hospital. The hospital divided them into two groups to treat. One was Group A (THP ·DDP · 5-FU combined with radiotherapy) with 42 patients, the other was Group B (radio therapy alone) with 40 patients. So patients in Group A were treated by THP 50mg/m2 ·day; DDP 80mg/m2 ·day and 5-FU 200mg /m2/ day for five consecutive days. Two days later after the induction chemotherapy was finished. NPC was began. Results: When radiotherapy was completed, the control rates of the tumor of nasopharyx of Group A and Group B were 88% and 67.5% (P<0.05) respectively. The tumor of neck of Group A and Group B were 87% and 40.4% (P<0.01) respectively; The complete remission CR of Group A and Group B were 90.4%, 52.5% (P<0.01 respectively). The overall 5-year survival of Group A and Group B were 50.0% (21/42) and 27.5% (11/40) (P<0.05) respectively. Conclusion: This study demonstrates that THP · DDP · 5-FU induction chemotherapy 1 cycles followed by radiotherapy can improve the latest curative effect and raise the rate of 5-year survival.