同期放化疗加辅助化疗治疗鼻咽癌的临床观察  

Clinical study of concurrent chemotherapy with PF protocol plus radiotherapy and adjuvant chemotherapy to nasopharyngeal carcinoma

作　　者：赵元华[1] 周晓艺[1] 何晓荣[1] 徐娇珍[1] 皮正超[1] 

机构地区：[1]湖北省肿瘤医院放疗科,湖北武汉430079

出　　处：《中华肿瘤防治杂志》2009年第6期451-453,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨放化疗同期治疗及辅助化疗对Ⅲ～ⅣA期鼻咽癌的临床疗效,评价鼻咽癌放化疗同期治疗及辅助治疗的毒副反应。方法:96例Ⅲ～ⅣA期鼻咽癌患者随机分为两组。A组为治疗组48例,采用常规放疗+同期化疗及辅助化疗;B组为对照组48例,单纯放疗。两组放疗方案相同,均采用6MVX线外照射+6～12MeV电子线,放疗技术为双面颈联合野DT36Gy后,改为双面颈联合小野避开脊髓加量放疗DT34Gy及下颈部切线野DT50Gy。鼻咽原发灶及阳性淋巴结区放疗DT70～78Gy,2Gy/次,下颈部及锁骨上淋巴结预防区DT50Gy。A组同期及辅助化疗方案为DDP30mg/m2,静脉滴入,d1～d3,或CBP60mg/m2,静脉滴入,d1～d5;5-FU600mg/m2,静脉滴入,d1～d5。3～4周为1个周期,放疗同期化疗2个周期,放疗后辅助化疗1、2周期。结果:A组3年无瘤生存率(DFS)为79.2%,B组为52.1%,χ2=7.804,P=0.005;A组3年总生存率(OS)为83.3%,B组为64.6%,χ2=4.381,P=0.036。结论:同期放化疗加辅助化疗能提高中晚期鼻咽癌的无瘤生存率及总生存率,毒副反应可耐受。OBJECTIVE：To evaluate the effects and toxicities of concurrent chemotherapy（CT） plus radiotherapy（RT） and adjuvant chemotherapy in the treatment of patients with nasopharyngeal carcinoma of stage Ⅲ-ⅣA. METHODS：A total of 96 cases of stage Ⅲ-ⅣA of nasopharyngeal carcinoma were randomly allocated into 2 groups. Group A： 48 patients were treated by 2 cycles of concurrent CT plus RT, plus 1-2 cycles adjuvant CT. Concurrent CT was given by PF protocal, DDP 30 mg/m^2, Ⅳ drop, d1-d3 or CBP 60 mg/m^2, iv drop, d1-d5; 5-FU 600 mg/m^2, iv drop, d1-d5, at the 1st week of RT, 2 cycles CT during the RT, plus 1-2 cycles adjuvant CT with the same protocol after RT. All 96 patients were treated by RT with 6 MV X-ray by the use of lateral facio-cervical fields to 36 Gy and 34 Gy by the use of small lateral facio-cervical fields in order to protect the cervical spinal cord, ＋6-12 MeV-β-ray, 2 Gy/F, 70-78 Gy to the primary carcinoma of nasopharynx and the positive cervicallymph nodes, 50 Gy to the region of negative lower cervical and super-clavicular lymph nodes by use of tangential field. Group B： 48 patients were treated by RT alone with the same method in Group A. RESULTS： In Group A and Group B, the 3-year disease free survival rates and the 3-year overall survival rates were 79.2% vs 52.1% （χ^2=7.804, P=0.005）;83.3% vs 64.6% （χ^2=4.381, P=0.036） respectively. There existed significant differences between the two groups. CONCLUSION： Concurrent CT plus RT and adjuvant CT is a safe and more effective therapy for patients with nasopharyngeal carcinoma of stage Ⅲ-ⅣA compared to RT alone, and the side effects were acceptable.

关 键 词：鼻咽肿瘤/放射疗法 鼻咽肿瘤/药物疗法 综合疗法 

分 类 号：R739.63[医药卫生—肿瘤]