中晚期鼻咽癌同步放化疗与序贯放化疗疗效比较  

A comparison of chemotherapy combined with radiotherapy concurrently and sequentially for advanced nasopharyngeal carcinoma

作　　者：马珺[1] 曹远东[1] 汤锐明 洪梅[1] 葛小林[1] 陈文湛[1] 孙新臣[1] 

机构地区：[1]东南大学附属中大医院肿瘤科,南京210009 [2]广东清远市第一人民医院放疗科

出　　处：《江苏医药》2010年第9期1027-1029,共3页Jiangsu Medical Journal

摘　　要：目的比较放化疗同步和序贯治疗中晚期鼻咽癌的疗效和毒副反应。方法 80例患者随机分成同步放化疗组(同步组)与先放疗后化疗组(序贯组),每组40例。采用多西他赛(TXT)+顺铂(DDP)方案化疗。放疗方法 :全部患者均接受根治性外照射,鼻咽和颈部及锁骨上靶体积采用全程调强放疗(IMRT)照射。结果治疗结束时,同步组和序贯组鼻咽病灶完全缓解率分别为77.5%和57.5%,颈部淋巴结病灶完全消退率为61.8%和38.9%;放疗结束6个月时的鼻咽病灶完全缓解率为92.5%和80.0%,同步组均显著高于序贯组(P<0.05)。两组生存曲线总生存率无明显差别。同步组皮肤反应和口腔黏膜炎较序贯组明显。结论 DP方案同步放化疗较序贯放化疗能提高中晚期鼻咽癌患者的肿瘤近期消退率,但部分不良反应有所增加。Objective To compare the outcomes of concurrent with sequent chemotherapy combined with radiotherapy for locally advanced（stageⅢ and Ⅳa） nasopharyngeal carcinoma（NPC）.Methods Eighty patients with locally advanced NPC were randomly divided into two groups with 40 cases each.Group A was treated with combined use of chemotherapy of taxotere （TXT）＋cisplatin（DDP） and intensity modulation radiated therapy（IMRT） simultaneously.Group B received IMRT at first,which was followed by chemotherapy of TXT＋DDP.Results After treatment,the complete remission rate of nasopharyngeal primary sites was higher in group A than that in group B（77.5% vs.57.5%）（P〈0.05）.So did the subsidence rate（61.8% vs.38.9%）（P〈0.05）.Six months later,the complete remission rate of nasopharyngeal primary sites was higher in group A than that in group B（92.5% vs.80.0%）（P〈0.05）.The survival curves of two groups had no statistical difference.The skin response and mucositis were more in group A than that in group B.Conclusion The regimen of TXT＋DDP concurrently combined with radiotherapy is superior to sequent chemoradiotherapy in the treatment of locally advanced NPC although some adverse responses were slightly increased.

关 键 词：鼻咽癌 放化疗 

分 类 号：R739[医药卫生—肿瘤]