诱导化疗加放射治疗晚期鼻咽癌86例分析  

Effectiveness of Combined Induction Chemotherapy and Radiotherapy i n Advanced Nasopharyngeal Carcinoma: Analysis of 86 cases

作　　者：张宜勤[1] 陈文湛[1] 

机构地区：[1]江苏省肿瘤医院放疗科,南京210009

出　　处：《南京医科大学学报（自然科学版）》2000年第5期384-386,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的　探讨诱导化疗加放疗在晚期鼻咽癌治疗中的作用。方法　 86例Ⅲ、Ⅳ期病人随机分成诱导化疗 +放疗的化放组和单纯放疗组。化放组的诱导化疗采用顺铂 (PDD) +5 氟脲嘧啶 (5 Fu)的PF方案。两组放疗均采用60 Co外照射。剂量 :原发灶Dt(肿瘤剂量 ) 70～ 80Gy,颈淋巴结Dt6 5～ 80Gy。对比两组的近、远期疗效。结果　全部病人均随访 5年以上。化放组和单放组鼻咽局部控制率分别为 90 .7%和 93.0 % (P >0 .0 5 )。化放组颈淋巴结的控制率明显优于单放组 ,分别为 76 .7%和 41 9% (P <0 0 1)。诱导化疗对颈转移性淋巴结有效率为 5 5 .8% ,有效者生存超过 5年的为 83.3% ,无效者仅为 15 8%(P <0 0 1)。化放组和单放组的 5年局部、颈部复发率和远处转移率分别为 7.0 % ,0 .0 % ,2 0 .9%和 9.3% ,2 .3% ,30 2 % ;1、3、5年生存率分别为 90 .6 %、73.6 %、6 6 .0 %和 6 7.5 % ,48.4% ,48.4% (P <0 .0 1)。结论　PF方案的诱导化疗提高了鼻咽癌颈淋巴结转移癌控制率 ,并延长了患者的生存期。Objective To evaluate the effects of combining induc tion chemotherapy with radiotherapy in advanced nasopharyngeal carcinoma (NPC).Methods From Sept 1981 to Sept 1993,86 patients with stage Ⅲ and Ⅳ NPC were randomly divided into two groups, one group was treated by induction ch emotherapy followed by radiotherapy (43 patients, CT-RT group) and the another, radiotherapy alone (43 patients, RT group). The induction chemotherapy was 2 cyc le PF regimens, cisplatin [DDP, 50 mg/(m 2·day), iv on day 1 and 3] and 5-f lu orouracil [5-Fu,800～1 000 mg/(m 2·day) by continuous iv infusion on days 1 ～4 ]. Both groups were received same radiotherapy with D_T 70～80 Gy to primary f ocus and D_T 65～80 Gy to cervical lymph nodes. The short-term and long-term treatment effects were compared between the two groups. Results All patients were followed up 5 years at least. Local control rate was similar in b oth groups, 90.7% in CT-RT and 93.0% in RT ( P >0.05). Nevertheless, the cer vical lymph nodes control rate in CT-RT was much higher than RT group (74.4% vs 41.9%, P <0.01). The response rate of cervical lymphadenopathy to induction chemotherapy was 58.8%. The 5-year survival rate in the patients responding to the chemotherapy was 83.3%, but in those not responding to the chemotherapy, on ly 15 8% ( P <0 01). The 5-year the local and regional recurrence rate and the distance metastasis rate in CT-RT and RT groups were 7.0%, 0%, 20.9% and 9.3%, 2.3%,30.2%, respectively ( P >0.05). The survival rates of the 1st, 3rd, and 5th year were 90.6%,73.6% and 66.0% in CT-RT group and 67.5%,48.4%,48.4% in RT group ( P <0 01).Conclusion The combining induction chemotherapy with RT regimen was good in the control rate of cervical lymphadenopathy and prolonged survival peri od of advanced NPC patients.

关 键 词：晚期鼻咽癌 药物疗法 放射疗法 诱导化疗 

分 类 号：R739.630.5[医药卫生—肿瘤]