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[目的]评价小剂量紫杉醇每周给药同步放疗对老年局部晚期鼻咽癌患者的疗效及毒副作用。[方法]88例老年局部晚期鼻咽癌患者,分为单纯放疗(对照组)43例,紫杉醇同步放疗(研究组)45例。[结果]研究组和对照组鼻咽全消率分别为95.6%、83.7%(P>0.05),颈淋巴结残留率分别为6.7%、23.3%(P<0.05);2年生存率分别为80.0%、60.5%(P<0.05),3、5年生存率分别为60.0%、51.2%和31.1%、23.3%,差异均无统计学意义。5年远处转移率分别为28.9%、34.9%,差异无统计学意义。毒副反应主要表现为白细胞减少和Ⅲ度口腔黏膜反应。[结论]小剂量紫杉醇每周化疗同步放疗可提高局部晚期鼻咽癌颈淋巴消除率,但未能明显提高远期生存率。
[Objective] To evaluate the curative effect and side effects of weekly low-dose paclitaxel concurrent radiotherapy on elderly patients with locally advanced nasopharyngeal carcinoma. [Method] 88 elderly patients with locally advanced nasopharyngeal carcinoma were divided into radiotherapy alone (control group) 43 cases, paclitaxel concurrent radiotherapy (study group) 45 cases. [Results] The total elimination rates of nasopharyngeal in study group and control group were 95.6% and 83.7%, respectively (P> 0.05). The residual rate of cervical lymph node was 6.7% and 23.3% (P <0.05) respectively. The 2-year survival rates were 80.0 %, 60.5% (P <0.05). The 3 and 5 year survival rates were 60.0%, 51.2% and 31.1% respectively, with no significant difference between them. The distant metastasis rates at 5 years were 28.9% and 34.9% respectively, with no significant difference. Toxic and side effects mainly manifested as leukopenia and Ⅲ degree oral mucosal reaction. [Conclusion] Weekly chemotherapy with low-dose paclitaxel can improve the rate of cervical lymph node dissection in locally advanced nasopharyngeal carcinoma, but not improve the long-term survival rate significantly.