新辅助化疗后放射治疗≥N_2期鼻咽癌的临床研究  

Neoadjuvant Chemotherapy (Plus Radiotherapy) in the Treatment of Patients with N2 Nasopharyngeal Carcinoma -A Randomized Clinical Study

作　　者：蔡长青[1] 王甦 廖万清[1] 宋维舒 王顺官 吴丹进 

机构地区：[1]解放军第一七七中心医院放疗科

出　　处：《中国肿瘤临床》1999年第6期420-422,共3页Chinese Journal of Clinical Oncology

摘　　要：目的：比较≥Ｎ２期鼻咽癌新辅助化疗后放疗与单纯放疗的临床效果。方法：自１９９３年１０月～１９９５年３月，８６例≥Ｎ２期经病理证实的鼻咽癌患者被随机分为新辅助化疗组（Ａ组）和单纯放疗组（Ｂ组），每组４３例。Ａ组于放疗前用ＤＦ方案（ＤＤＰ、５ＦＵ）化疗２～３周期。两组放疗方法相同，全部病例用４ＭｅＶ光子线常规分割放疗，鼻咽部剂量６５～８０Ｇｙ／６５～８周，颈部剂量５８～７２Ｇｙ／５８～７２周。结果：Ａ组和Ｂ组鼻咽部肿瘤完全消退率分别为８８４％和９３５％，颈部转移淋巴结完全消退率分别为９０７％和９３５％，均无显著性差异（Ｐ＞００５）。两组３年生存率分别为７１８％和５６６％，Ａ组高于Ｂ组（Ｐ＜００５）。３年鼻咽部肿瘤局控率和颈部转移淋巴结控制率Ａ组均高于Ｂ组（均为Ｐ＜００１）。Ａ、Ｂ两组远处转移率分别为２０８％和３０２％，有显著性差异（Ｐ＜００５）；平均转移时间分别为１９个月和９个月，两组有显著性差异（Ｐ＜００１）。Ａ组急性毒副反应较Ｂ组重，但未影响治疗进程。结论：对≥Ｎ２期颈淋巴结转移的鼻咽癌患者放疗前化疗（新辅助化疗）能提高患者生存率和局部控制率，减少远处转移，延长出现转移的时?Purpose: To compare the effect of neoadjuvant chemotherapy (plus radiotherapy) and radiotherapy alone Methods: From October 1993 to March 1995, 86 patients with histologically proven N2 nasopharyngeal carcinoma (NPC) were randomized into two groups: Group A (43 cases) was treated with neoadjuvant therapy, receiving radiotherapy of 65-80Gy/65-8W to the nasoparynx and 58-72 Gy/58-72W to the neck after 2-3 cycles of chemotherapy with PF protocol (5-Fu and cisplatin DDP) Group B (43 cases) received the same radiotherapy alone Results: The complete response rates in the groups A and B were 884%and 935%respectively with no significant difference (P >005) The 3-year survival rate of A group was higher than that of the B group (718%vs 566%) (P< 005) The 3-year primary lesion and cervical node control rate of group A was higher than that of group B (P< 001) The mean interval to appearance of distant metastasis was 19 months in group A and 9 months in group B with significant difference (P< 001) Conclusion: Neoadjuvant chemotherapy (plus radiotherapy)can increase the survival rate and local disease control, and can delay distant metastasis in patients with N2 nasopharyngeal carcinoma

关 键 词：鼻咽癌 新辅助化疗 放射疗法 治疗 

分 类 号：R739.630.5[医药卫生—肿瘤]