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目的探讨调强适形放疗(IMRT)联合顺铂化疗治疗鼻咽癌的临床疗效。方法选取2013年10月至2015年12月间广东省肇庆市第二人民医院收治的80例鼻咽癌患者,根据治疗方法不同分为IMRT组41例和联合组39例。IMRT组采用IMRT治疗,联合组采用IMRT联合顺铂化疗治疗,比较两组患者放疗结束后1年和3年的生存率和远期疗效,评价两组患者治疗不良反应。结果联合组患者3年无瘤生存率和3年无进展生存率均高于IMRT组患者,差异均有统计学意义(均P<0.05)。两组患者1年无瘤生存率和1年无进展生存率,及1年和3年的无局部复发生存率和无远处转移生存率比较,差异均无统计学意义(均P>0.05)。联合组患者2年和3年生存率均高于IMRT组患者,差异均有统计学意义(均P<0.05)。联合组患者颈部淋巴结肿瘤体积(GTVnd)缩小比例高于IMRT组,皮下纤维化率低于IMRT组,差异均有统计学意义(均P<0.05)。两组患者口干率、听力受损率和肝功能受损率比较,差异均无统计学意义(均P>0.05)。结论调强适形放疗联合顺铂化疗治疗鼻咽癌远期疗效较好,能有效降低不良反应,提高术后生存率。
Objective To investigate the clinical effect of intensity modulated conformal radiotherapy (IMRT) and cisplatin chemotherapy in the treatment of nasopharyngeal carcinoma. Methods Eighty patients with nasopharyngeal carcinoma who were admitted to the Second People’s Hospital of Zhaoqing City, Guangdong Province from October 2013 to December 2015 were selected and divided into IMRT group (n = 41) and combination group (n = 39) according to different treatment methods. The IMRT group was treated with IMRT. The combined group was treated with IMRT plus cisplatin chemotherapy. The 1-year and 3-year survival rates and long-term efficacy after radiotherapy were compared between the two groups. The adverse reactions were evaluated in both groups. Results The 3-year disease-free survival rate and 3-year progression-free survival rate in the combined group were significantly higher than those in the IMRT group (all P <0.05). The 1-year disease-free survival rate, 1-year progression-free survival rate, and 1-year and 3-year non-local recurrence survival rate and distant metastasis-free survival rate were not significantly different between the two groups (all P> 0.05) . The 2-year and 3-year survival rates in the combined group were significantly higher than those in the IMRT group (all P <0.05). The reduction rate of GTVnd in the combined group was higher than that in the IMRT group, and the subcutaneous fibrosis rate was lower than that in the IMRT group (all P <0.05). There was no significant difference between the two groups in the rate of dry mouth, hearing loss and impaired liver function (all P> 0.05). CONCLUSION: Intensity-modulated conformal radiotherapy combined with cisplatin chemotherapy has a good long-term therapeutic effect on nasopharyngeal carcinoma, which can effectively reduce the adverse reactions and improve the postoperative survival rate.