328例鼻咽癌放、化(PV)综合治疗远近期疗效的前瞻随机研究

COMBINATION OF CHEMOTHERAPY AND RADIOTHERAPY VS RADIOTHERAPY ALONE IN THE TREATMENT OF NASOPHARYNGEAL CARCINOMA(NPC) A PROSPEC TIVE RANDOMIZIED STUDY ON 328 PATIENTS

本文报道1984—1989年328例鼻咽癌放疗与放、化综合治疗的前瞻性随机研究结果。其中单放组173例,综合组155例。结果表明,放化(DDP 20mg Q.d×5,VCR 1.5mg.d1,d5,化疗用于放疗前及/或放疗后)综合治疗的近期完全缓解率(CR)43.9％高于单放组的32.9％(P<0.05);3,4,5年生存率综合组分别为76.5％、64.7％、54.0％高于单放组的70.0％,59.4％,50.3％。Ⅱ、Ⅲ期病例的远处转移率,综合组(7.6％,7.8％)低于单放组(11.5％,11.7％)。但两组的1,2年生存率;局部复发率,中位生存时间等无明显差异。资料表明,综合治疗对提高Ⅱ期以上病例的近期完全缓解率有肯定好处,对减少Ⅱ、Ⅲ期病例的远处转移率,提高3、4、5年生存率也有一定效果。

A prospective randomized clinical study on the combination of radiotherapy and chemotherapy (R+C) vs radiotherapy alone(R) was conducted during the period 1984 through 1989 on 328 NPC patients. In R+C group there were 173 and in R group 155 patients. The radiotherapy of these two groups were similar, using 60Co to deliver 60-80 Gy in 6-8 weeks to the primary tumor and 50-60 Gy in 6-8 weeks by 60Co plus X-ray for neck metastasis. Chemotherapy was given by PV regimen (DDP 20 mg Q.d×5, VCR 1.5mg d1,d5) before and/or after radiotherapy. All patients were followed up. The CR rate in R+C group(43.9%) was singnificantly higher than in R group (32.9%), (P<0.05). The 3,4 and 5 year survival rates were 76.5%, 64.7%,. 54.8% in R+C and 70.2%, 59.4%, 50.3% in R group, respectively. The rates of distant metastasis in Stage Ⅰ or Ⅱ patients were 7.6%, 7.8% in R+C group and 11.5%, 11.7% in radiotherapy alone group. The 1 or 2 year survival rate, local recurrence rate, median survival period were not sugnificantly different between these two group. These data , showed that combination of chemotherapy and radiotheranpy was favorable in raising the complete remission rate and reducing the metastasis of Stage Ⅱ or Ⅲ of NPC.