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目的:探讨用PF方案同期化疗联合放射治疗局部中晚期鼻咽癌5年疗效。方法:52例局部中晚期鼻咽癌患者,在放疗第1、5周联合PF方案化疗,DDP70 mg/m2,d1,静脉滴入;5-FU 500 mg/m2,d2起96 h静脉灌注,共2个周期。另配对选取同时期52例单纯放疗者为对照组,两组放疗方法和剂量相似。结果:治疗结束后3个月,鼻咽肿物完全缓解率,同期组高于单放组,P=0.014。>3级毒副反应发生率同期组>单放组,P<0.05。5年总生存率、无局部复发生存率和无远处转移生存率,同期组较单放组分别为78.8%vs57.1%(P=0.016)、97.9%vs76.0%(P=0.002)和80.7%vs76.6%(P=0.674)。分层分析,T晚期(T3-4N0-1M0)同期组仅在5年无局部复发生存率明显提高(P=0.025),N晚期(T1-4N2-3M0)同期组在5年无局部复发生存率、总生存率均有提高(P=0.038;P=0.008),5年无远处转移生存率差异无统计学意义(P=0.146)。结论:PF方案同期化放疗提高了局部中晚期鼻咽癌5年总生存率及无局部复发生存率;对提高N晚期病例的无远处转移生存率也有潜在获益。
Objective: To investigate the efficacy of PF regimen combined with concurrent radiotherapy in the treatment of locally advanced advanced nasopharyngeal carcinoma for 5 years. Methods: Fifty-two patients with locally advanced nasopharyngeal carcinoma were treated with PF regimen in the first and fifth week of radiotherapy, DDP (70 mg / m2, d1) A total of 2 cycles. The other pairs were selected during the same period of 52 cases of radiotherapy alone as a control group, two groups of radiotherapy methods and doses similar. Results: Three months after the end of treatment, the complete remission rate of nasopharyngeal tumor was higher in the same period than in the single operation group (P = 0.014). > Grade 3 Toxicity Incidence Group> Group B, P <0.05. 5. 5-year overall survival, no local recurrence and no distant metastasis survival rate, 78.8% vs57 respectively. 1% (P = 0.016), 97.9% vs 76.0% (P = 0.002) and 80.7% vs 76.6% (P = 0.674). By stratified analysis, there was no significant difference between the two groups (P = 0.025) in 5 years in the T group (T3-4N0-1M0), and no local recurrence in the N group (T1-4N2-3M0) (P = 0.038; P = 0.008). There was no significant difference in the 5-year survival without distant metastasis (P = 0.146). CONCLUSIONS: PF regimen concurrent chemoradiotherapy improves the 5-year overall survival and local recurrence-free survival of locally advanced and late stage nasopharyngeal carcinoma. It also has the potential benefit of improving the distant metastasis-free survival of advanced stage N patients.