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目的探讨紫杉醇同期放化疗治疗局部晚期鼻咽癌(T4N2～3M0)的临床疗效及不良反应。方法 2005年1月至2006年5月我院收治经病理确诊为低分化鳞癌的鼻咽癌患者,按福州分期T4N2～3M0,共60例,随机分为同期放化疗组(30例)和单纯放疗组(30例)。同期放化组化疗方案:在放疗同时给予紫杉醇60mg,每周1次,共7次;放疗方案同单纯放疗组。结果放疗结束后3个月,同期放化组、单纯放疗组鼻咽肿瘤完全消退率分别为93.3%和86.7%(P>0.05),1,2,3年局控率同期放化组、单纯放疗组分别为93.3%、86.7%、66.7%和90.9%、63.3%、43.3%。1,2,3年生存率分别为96.7%、83.3%、76.7%和86.7%、66.7%、53.3%。同期放化组的白细胞下降、消化道反应等毒性副反应明显高于单纯放疗组(P<0.05),但不延长放疗总疗程。结论同期放化疗治疗局部晚期鼻咽癌有助于提高生存率,减少局部复发和远处转移。
Objective To investigate the clinical efficacy and side effects of paclitaxel concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (T4N2 ~ 3M0). Methods From January 2005 to May 2006, patients with nasopharyngeal carcinoma diagnosed as poorly differentiated squamous cell carcinoma by pathology in our hospital were divided into four groups according to the stage of T4N2 ~ 3M0 in Fuzhou. A total of 60 cases were randomly divided into radiotherapy and chemotherapy group (30 cases) and Radiotherapy alone group (30 cases). The same period radiotherapy and chemotherapy group: in the radiotherapy given paclitaxel 60mg, once a week for a total of 7 times; radiotherapy program with a simple radiotherapy group. Results Three months after the end of radiotherapy, nasopharyngeal neoplasms in radiotherapy group and radiotherapy group were completely relieved at 93.3% and 86.7%, respectively (P> 0.05) The radiotherapy group was 93.3%, 86.7%, 66.7% and 90.9%, 63.3% and 43.3% respectively. The 1, 2, 3 year survival rates were 96.7%, 83.3%, 76.7% and 86.7%, 66.7% and 53.3% respectively. The same time, radiotherapy group leukopenia, gastrointestinal reactions and other toxic side effects were significantly higher than radiotherapy alone group (P <0.05), but did not extend the total course of radiotherapy. Conclusions Concurrently with radiotherapy and chemotherapy for locally advanced nasopharyngeal carcinoma, it is helpful to improve the survival rate and reduce the local recurrence and distant metastasis.