论文部分内容阅读
[目的]评价诱导化疗加同期放化疗治疗T3～4N2～3M0期鼻咽癌的疗效。[方法]2008年5月至2009年6月112例T3～4N2～3M0期鼻咽癌患者随机分为试验组和对照组,两组患者均接受相同的放疗方案。试验组57例接受诱导化疗加同期放化疗,对照组55例接受单纯同期放化疗,诱导化疗方案为PF方案,即DDP30mg/m2,d1～3+5-Fu450mg/m2,d1～3,1次/3周,共2个周期。同期放化疗在诱导化疗结束后3周进行,方案为DDP40mg/m2,每周1次。[结果]中位随访42个月,随访率98.2%,全组3年总生存率为79.3%,试验组和对照组3年总生存率、无瘤生存率、无远处转移生存率、无复发生存率分别为80.5%vs76.2%(P=0.937);63.1%vs57.9%(P=0.653);68.2%vs62.6%(P=0.692);84.1%vs74.4%(P=0.345)。试验组3～4级白细胞减少、黏膜炎发生率分别是21.1%和31.6%,显著高于对照组的5.5%和9.1%(P<0.05)。[结论]诱导化疗加同期放化疗与单纯同期放化疗相比并不能提高T3～4N2～3M0期鼻咽癌3年总生存率、无瘤生存率、无远处转移生存率和无复发生存率。建议推行大样本随机临床对比研究,以进一步明确诱导化疗加同期放化疗治疗局部晚期鼻咽癌的疗效。
[Objective] To evaluate the efficacy of induction chemotherapy plus concurrent chemoradiotherapy for treatment of nasopharyngeal carcinoma of T3 ~ 4N2 ~ 3M0 stage. [Methods] From May 2008 to June 2009, 112 patients with T3 ~ 4N2 ~ 3M0 nasopharyngeal carcinoma were randomly divided into experimental group and control group, and both groups received the same radiotherapy regimen. In the experimental group, 57 cases received induction chemotherapy plus concurrent chemoradiotherapy and 55 cases in the control group received concurrent chemoradiotherapy. The induction chemotherapy regimen was PF regimen, ie DDP30mg / m2, d1-3 + 5-Fu450mg / m2, d1-3,1 times / 3 weeks, a total of 2 cycles. The same period of radiotherapy and chemotherapy in induction chemotherapy after 3 weeks, the program is DDP40mg / m2, once a week. [Results] The median follow-up was 42 months. The follow-up rate was 98.2%. The overall 3-year overall survival rate was 79.3%. The 3-year overall survival rate, tumor-free survival rate, distant metastasis- The recurrence rates were 80.5% vs 76.2% (P = 0.937), 63.1% vs 57.9% (P = 0.653), 68.2% vs62.6% (P = 0.692), 84.1% vs74.4% (P = 0.345). Grade 3-4 leukopenia and mucositis in trial group were 21.1% and 31.6% respectively, which were significantly higher than those in control group (5.5% vs 9.1%, P <0.05). [Conclusion] Chemotherapy plus concurrent chemoradiotherapy can not improve the 3-year overall survival, tumor-free survival, distant metastasis-free survival and recurrence-free survival of patients with stage T3 ~ 4N2 ~ 3M0 nasopharyngeal carcinoma . Recommended the implementation of large randomized clinical comparative study to further clarify the induction of chemotherapy plus concurrent radiotherapy and chemotherapy for the treatment of locally advanced nasopharyngeal carcinoma.