PF方案化疗同步放射治疗局部中晚期鼻咽癌的5年疗效分析  

Five-year efficacy analysis of PF chemotherapy combined with radiotherapy in patients with local-advanced nasopharyngeal Carcinoma

作　　者：曾睿芳[1] 苏勇[1] 邓雪英[2] 夏云飞[1] 吴峥[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心放疗科,广东广州510060 [2]东莞市人民医院放疗科,广东东莞523000

出　　处：《中华肿瘤防治杂志》2011年第1期43-46,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨用PF方案同期化疗联合放射治疗局部中晚期鼻咽癌5年疗效。方法:52例局部中晚期鼻咽癌患者,在放疗第1、5周联合PF方案化疗,DDP70 mg/m2,d1,静脉滴入;5-FU 500 mg/m2,d2起96 h静脉灌注,共2个周期。另配对选取同时期52例单纯放疗者为对照组,两组放疗方法和剂量相似。结果:治疗结束后3个月,鼻咽肿物完全缓解率,同期组高于单放组,P=0.014。>3级毒副反应发生率同期组>单放组,P<0.05。5年总生存率、无局部复发生存率和无远处转移生存率,同期组较单放组分别为78.8%vs57.1%(P=0.016)、97.9%vs76.0%(P=0.002)和80.7%vs76.6%(P=0.674)。分层分析,T晚期(T3-4N0-1M0)同期组仅在5年无局部复发生存率明显提高(P=0.025),N晚期(T1-4N2-3M0)同期组在5年无局部复发生存率、总生存率均有提高(P=0.038;P=0.008),5年无远处转移生存率差异无统计学意义(P=0.146)。结论:PF方案同期化放疗提高了局部中晚期鼻咽癌5年总生存率及无局部复发生存率;对提高N晚期病例的无远处转移生存率也有潜在获益。OBJECTIVE： This study was to investigate the 5-year efficacy of PF chemotherapy combined with radiotherapy in local-advanced nasopharyngeal carcinoma. METHODS： A total of 52 eligible patients with local-advanced NPC （CRT group） received two cycles of concurrent chemotherapy with cisplatin 70 mg/m2 intravenously on day 1 plus 5-fluorouracil 500 mg/m2 by 96-hour continuous infusion on day 2, during the weeks 1 and 5 of radiotherapy. Another 52 patients （RT group） matched with the CRT group were treated with radiotherapy alone. Similar dosage and fractionation of radiotherapy were administered in both groups. RESULTS： Three months after radiotherapy, the complete response rate of nasopharynx in CRT group was significantly higher than that in RT group（P=0. 014）. The rates of grades 3 and 4 systemic toxicities were significantly more severe in CRT group. The 5-year overall survival rate, 5-year local-regional failure free survival rate and the 5-year distant failure-free survival rate for the CRT and RT groups were 78. 8% vs 57. 1%（P=0.016）, 97. 9% vs 76.0% （P=0. 002） and 80. 7% vs 76. 6% （P=0. 674）, respectively. In a sub- group analysis, for patients with local-advanced T stage （T3-4 N0-1Mo ）, the CRT arm only achieved significantly higher at 5-year failure-free survival rate （P=0. 025）. For patients with local-advanced N stage （T1-4 N2-3 M0 ）, the CRT group achieved significantly higher at 5-year failure-free survival rate （P=0. 038） and at 5-year overall survival rate （P=0. 008）, however, the 5-year distant control did not improve significantly （P= 0. 146）. CON- CLUSIONS： The PF chemotherapy combined with radiotherapy may improve the 5-year survival rate and 5-year local-regional failure-free survival rate on local-advanced nasopharyngeal carcinoma. It has potential efficacy to enhance distant failure-free survival rate on local-advanced N stage.

关 键 词：鼻咽肿瘤/药物疗法 鼻咽肿瘤/放射疗法 综合疗法 顺铂/治疗应用 氟尿嘧啶/治疗应用 

分 类 号：R739.63[医药卫生—肿瘤]