论文部分内容阅读
目的:中晚期鼻咽癌局部复发和远处转移率较高,采用单纯放疗其疗效不甚理想。有研究报道同期放化疗能提高中晚期鼻咽癌患者的疗效,本研究着重探讨放疗同期化疗治疗中晚期鼻咽癌的疗效。方法:将60例Ⅲ、ⅣA期鼻咽癌患者随机分为放疗同期化疗组(研究组)及单纯放疗组(对照组)每组各30例,研究组于放疗第1周开始,使用FD方案,顺铂20mg/m2,加入250ml0.9%氯化钠注射液,静脉滴注,第1~4天;氟尿嘧啶600mg/m2,加入500ml0.9%氯化钠注射液,静脉滴注,第1~5天。21d/次,连用6次。放疗采用常规分割放疗,2GY/次/d,5次/周。病灶区剂量70GY/35次,颈部淋巴引流区给予预防剂量56GY/28次或治疗剂量70GY/35次。对照组单纯放疗,方法同研究组放疗。结果:研究组与对照组相比明显提高了Ⅲ、ⅣA期鼻咽癌患者的颈部淋巴结完全缓解率以及1、3、5年生存率和无瘤生存率;显著降低了远处转移发生率,两组相比差异有统计学意义。结论:同期放化疗较单纯放疗提高了中晚期鼻咽癌的颈部淋巴结完全缓解率以及1、3、5年生存率和无瘤生存率,显著降低了远处转移的发生率。
Objective: In advanced nasopharyngeal carcinoma, local recurrence and distant metastasis rate are higher, the effect of radiotherapy alone is not ideal. Studies have reported that concurrent chemoradiotherapy can improve the efficacy of patients with advanced nasopharyngeal carcinoma. This study focused on the concurrent chemotherapy with radiotherapy in the treatment of advanced nasopharyngeal carcinoma. Methods: Sixty patients with stage Ⅲ and ⅣA nasopharyngeal carcinoma were randomly divided into radiotherapy and chemotherapy group (study group) and radiotherapy group (control group), 30 patients in each group. The study group began radiotherapy in the first week, , Cisplatin 20mg / m2, adding 250ml0.9% sodium chloride injection, intravenous drip, the first to 4 days; fluorouracil 600mg / m2, adding 500ml0.9% sodium chloride injection, intravenous infusion, the first ~ 5 days. 21d / time, once every 6 times. Radiotherapy using conventional radiotherapy, 2GY / time / d, 5 times / week. Focal area dose of 70GY / 35 times, the neck lymphatic drainage area to give a preventive dose of 56GY / 28 times or the therapeutic dose of 70GY / 35 times. Control group radiotherapy alone, the same method with the study group radiotherapy. Results: Compared with the control group, the study group significantly improved the complete remission rate of cervical lymph nodes and the 1,3 and 5 year survival rates and tumor-free survival rate in patients with stage Ⅲ and ⅣA nasopharyngeal carcinoma, and significantly reduced the incidence of distant metastasis , The difference between the two groups was statistically significant. Conclusions: Radiotherapy combined with radiotherapy alone in the same period improves the complete remission rate of cervical lymph nodes and the 1,3 and 5 year survival rates and tumor-free survival rates of patients with advanced nasopharyngeal carcinoma and significantly reduces the incidence of distant metastases.