奈达铂联合紫杉醇同期调强放射治疗初治晚期鼻咽癌的临床观察  

Clinical study of first-treated advanced nasopharyngeal carcinoma patients for intensity modulated radiationtherapy (IMRT) combined with paclitaxel and Nedaplatin chemotherapy

作　　者：徐池[1] 宋丹[1] 姜雪松[1] 

机构地区：[1]江苏省肿瘤医院放疗科,南京210009

出　　处：《齐齐哈尔医学院学报》2009年第24期3019-3021,共3页Journal of Qiqihar Medical University

摘　　要：目的研究鼻咽癌调强放射治疗(IMRT)的投照方式及放化结合的耐受性和近期临床疗效。方法初治鼻咽癌患者121例中,Ⅲ期84例,Ⅳa期37例。鼻咽和全颈及锁骨上全程实施前7野IMRT技术照射。同时给予紫杉醇+奈达铂方案化疗2周期,间隔4周。采用Kaplan-Meier法进行生存分析,RTOG标准评价急性反应和晚期损伤。结果中位随访时间16个月,1、2年局部区域无进展生存率分别为95.4%、92.9%;1、2年无远处转移生存率分别为91.6%、87.4%。1、2年总生存率为94.3%、86.7%。患者近期毒副反应可以耐受,口干症状随着治疗后时间的延长口干逐渐减轻。结论IMRT初治鼻咽癌可获得理想的局部区域控制,对正常组织器官有较好的保护作用;紫杉醇+奈达铂放化综合治疗对控制远处转移有一定价值,毒副反应可以耐受。Objective To study radiationfields,toleration of radiation therapy combined chemotherapy,clinical efficacy of intensity modulated radiation therapy（IMRT）for first-treated advanced nasopharyngeal carcinoma.Methods From July 2007 to June 2009,121 patients with first-treated advanced nasopharyngeal carcinoma underwent IMRT at the Jiangsu Cancer Hospital.According to the Fuzhou Staging Classification,84 stage Ⅲ,and 37 stage Ⅳ.All of the first-treated nasopharyngeal carcinoma were treated with 7 front radiation fields for full course IMRT including nasopharynx and full neck to supraclavicle.All patients＇ treatment combined with paclitaxel and nedaplatin chemotherapy Kaplan-Meier method was to calculate the local-regional progression-free rate,distant metastasis-free rate,and overall survival.Acute and late toxicities were graded according to RTOG radiation morbidity scoring criteria.Results The 1-,2-year estimated local-regional progression-free survival rates,distant metastases-free survival rates and overall survival rates was 95.4%,92.9%;91.6%,87.4% and 94.3%,86.7%.Conclusions IMRT yields well dose distribution and acceptable toxicity in first-treated nasopharyngeal carcinoma.Radiation therapy combined with chemotherapy is effectors to control distant metastasis.

关 键 词：鼻咽肿瘤 调强放射治疗 紫杉醇 奈达铂 

分 类 号：R730.55[医药卫生—肿瘤] R739.63[医药卫生—临床医学]