后程加速超分割放疗加紫杉醇治疗局部晚期鼻咽癌疗效观察  

Observation on clinical affect of Late course accelerated hyperfractionation radiotherapy plus paclitaxel for locally advanced nasopharyngeal carcinoma

作　　者：杨春晖陈雍王远飞 杨春晖[1] 陈雍[1] 王远飞[1] 

机构地区：[1]黄山市人民医院,245000

出　　处：《安徽医学》2009年第6期625-627,共3页Anhui Medical Journal

摘　　要：目的探讨后程加速超分割放疗加紫杉醇治疗局部晚期鼻咽癌的近期疗效和毒副反应。方法2005年3月至2008年7月,应用后程加速超分割放疗加紫杉醇治疗局部晚期鼻咽癌36例。放射治疗先期采用60Co机面颈联合野加下半颈前切线野常规分割照射至上颈髓36Gy后,鼻咽部改为耳前野后程加速超分割照射,DT1.5Gy/F,2次/天(间隔6h),10次/W,鼻咽部总剂量69Gy/6W/42F,少数为70～72Gy。后程加速超分割照射的同时每周给予紫杉醇60mg静脉滴注,共3周。观察综合治疗的近期疗效和毒副反应。结果放疗结束时和放疗结束后3个月鼻咽部原发病灶CR率分别为94.4%、97.2%;颈部转移灶CR率分别为91.7%、94.4%。近期毒副反应主要为急性口腔黏膜炎和白细胞下降,经支持对症处理患者均可耐受,全部病例均按时完成治疗计划。结论后程加速超分割放疗加紫杉醇治疗局部晚期鼻咽癌近期疗效好、毒副反应适中,患者易于耐受。远期疗效和毒副反应有待临床进一步研究。Objective To investigate the recent efficacy and toxicity of late-course accelerated hyperfractionation radiotherapy plus paclitaxel in locally advanced nasopharyngeal carcinoma. Methods Used and observed the application of late-course accelerated hyperfractionation radiotherapy plus paclitaxel treatment on 36 cases of locally advanced nasopharyngeal carcinoma from March 2005 to July 2008. in the early-course of the radiotherapy, the Co60 machine radiotherapy was used in the face and neck joint area plus in the lower half of the neck anterior diagram view using standardized conventional fractionated irradiation 36Gy supremacy cervical spinal cord, and in the area of nasopharynx preauricular going through the front of the ears, replaced with late-course accelerated hyperfractionated irradiation, DT1.5Gy / F, 2 times / day （6 hours intervals）, 10 times/W, total dosage in the nasopharynx area is： 69Gy/6W/42F, few cases are： 70 - 72Gy. While Late-course accelerated hypeffractionated irradiation was applied, weekly 60rag paclitaxel intravenous drip were given concurrently for three weeks. The short-term affect and toxicity of this comprehensive treatment were observed. Resealts CR rates of primary nasopharyngeal lesion were 94.4%, 97.2%; CR rates of neck metastases were 91.7%, 94.4% three months after the end of radiotherapy. The short-term toxicity reaction was acute oral mucositis and leukopenia, with the support of symptomatic treatments, can be tolerated, all treatment plans were completed within scheduled time with all cases. Conclusion Late-course accelerated hyperfractionation radiotherapy plus paclitaxel for locally advanced nasopharyngeal carcinoma have a good short-term efficacy, moderate toxicity; patients can easily tolerate. Long-term efficacy and toxicity should be observed for further study.

关 键 词：局部晚期鼻咽癌 后程加速超分割 放疗 紫杉醇 

分 类 号：R735.1[医药卫生—肿瘤] R739.63[医药卫生—临床医学]