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目的探讨同期放化疗治疗鼻咽癌肿瘤残留与预后的关系。方法80例鼻咽癌患者随机分为两组:单纯常规放疗组(A组)42例。常规放疗+同期化疗(B组)38例。原发灶和阳性淋巴结区DT70～76Gy/35～38次,7～8周,预防区DT50～60Gy/25～30次,5～6周。化疗方案为顺铂(DDP)20mg/m2静脉滴注,d1～5,5-氟尿嘧啶(5-FU)750mg/m2静脉滴注,d1～5,每3周1个疗程,共2个疗程,并分析鼻咽部及颈部肿瘤残留情况。结果3年无瘤生存率(DFS)A组45.23%(19/42)、B组71.1%(27/38),二者差异有统计学意义(χ2=5.47,P<0.05);3年总生存率(OS)A组57.1%(24/42),B组73.6%(28/38),二者差异无统计学意义(χ2=2.38,P>0.05);鼻咽癌放射治疗后有残留者较无残留者的1、3、5年生存率低;颈部残留灶越大,生存率越低;有残留者的局部复发率增高。结论鼻咽癌放射治疗后有残留者的生存率下降,放射治疗后肿瘤残留可作为判断预后的一个指标。
Objective To investigate the relationship between radiotherapy and chemotherapy in the treatment of residual tumor and prognosis of nasopharyngeal carcinoma. Methods Eighty patients with nasopharyngeal carcinoma were randomly divided into two groups: 42 patients in the conventional radiotherapy group (group A). Conventional radiotherapy + concurrent chemotherapy (group B) 38 cases. Primary tumor and positive lymph node area DT70 ~ 76Gy / 35 ~ 38 times, 7 ~ 8 weeks, prevention area DT50 ~ 60Gy / 25 ~ 30 times, 5 ~ 6 weeks. Chemotherapy regimens were intravenous drip of 20mg / m2 cisplatin (DDP) and 750mg / m2 of d1 ~ 5,5- fluorouracil (d-5) once every 3 weeks for 2 courses, And analyze the nasopharyngeal and neck tumor residue. Results The 3-year disease-free survival (DFS) was 45.23% (19/42) in group A and 71.1% (27/38) in group B, with significant difference between the two groups (χ2 = 5.47, P <0.05) The survival rate was 57.1% (24/42) in group A and 73.6% (28/38) in group B. There was no significant difference between the two groups (χ2 = 2.38, P> 0.05) Those with no residual one, three and five years survival rate is low; the larger the residual neck of the neck, the lower the survival rate; those with residual local recurrence rate increased. Conclusion The survival rate of patients with residual NPC after radiotherapy is decreased. The residual tumor after radiotherapy can be used as an index to judge the prognosis.