诱导加同期放化疗对局部晚期鼻咽癌的临床疗效  

Clinical Efficacy of Induction Chemotherapy Plus Concurrent Radiochemotherapy for Locoregionally Advanced Nasopharyngeal Carcinoma

作　　者：梁锦辉[1] 钟伟铭 雷章华 邓滨[1] 

机构地区：[1]广西梧州市红十字会医院放疗科,543002

出　　处：《实用癌症杂志》2013年第6期744-747,共4页The Practical Journal of Cancer

摘　　要：目的探讨诱导加同期放化疗对局部晚期(Ⅲ、Ⅳa期)鼻咽癌的临床疗效。方法对101例Ⅲ、Ⅳa期鼻咽癌患者行诱导加同期放化疗(IC组),同时与同期行单纯放疗的102例(RT组)进行比较,两组放疗方法相同。诱导加同期放化疗组放疗前诱导化疗2个周期:DDP 20 mg/m2,d1-5;5-Fu 500 mg/m2,d1-5;21天为1个周期,同期化疗于放疗第1、4周进行;DDP 20 mg/m2,d1-3;5-Fu 500 mg/m2,d1-3。结果诱导加同期放化疗组及单纯放疗组鼻咽肿瘤全消率分别为95.0%和83.3%(P<0.05);颈部淋巴结全消率分别为94.1%和82.3%(P<0.05);5年总生存率为72.3%和51.0%(P<0.05);5年无进展生存率为68.3%和48.0%(P<0.05);局部复发率为17.8%和33.3%(P<0.05);远处转移率为17.8%和29.4%(P<0.05)。结论诱导加同期放化疗可提高Ⅲ、Ⅳa期鼻咽癌肿瘤全消(CR)率、5年总生存率和无瘤生存率,降低局部复发率和远处转移率。DDP联合5-Fu的方案急性不良反应仍较重。Objective To evaluate the clinical efficacy of induction chemotherapy plus concurrent radiochemotherapy for loeoregionally advanced nasopharyngeal carcinoma（NPC） at stage Ⅲ-Ⅳa. Methods 101 NPC cases were treated with induction chemotherapy plus concurrent radioehemotherapy（ group IC ）. 102 cases were treated with radiotherapy alone（ group RT）. Identi- cal radiotherapy program had been applied to two treatment groups. Additional treatment of 2 cycles cisplatiu（20 mg/m2 ） plus 5- fluorouracil（500 mg/m2） daily for 5 days, repeated every 3 weeks before the radiotherapy;and 2 cycles cisplatin （20 mg/m2） plus 5-fluorouracil （500 mg/m2） daily for 3 days, repeated every 4 weeks from the first day of radiotherapy were applied to group IC. Results The complete remission（CR） rates of nasopharynx tumor were 95.0% and 85.3% （ P 〈 0.05） ;the CR rates of cervical lymph node were 94.1% and 83.3% （ P 〈 0.05 ） ; the 5-year overall survival （OS） rates were 72.3% and 51.0% （ P 〈 0.05 ） ; the 5-year progression-free survival （PFS） rates were 68.3% and 48.0% （ P 〈 0.05 ） ; the local recurrence rates were 17.8% and 33.3% （P 〈 0.05） ;the distant metastasis rates were 17.8% and 29.4% （P 〈 0.05）. Conclusion Induction chemotherapy plus concurrent radiochemotherapy for NPC cases at stage III-IV a could significantly improve the CR rate,5-year OS rate ,5-year PFS rate, and decrease local recurrence rates, distant metastasis rates. However, a severe acute reaction also has been shown in the cases with the PF（cisplatin ＋ 5-fluorouracil） regimen.

关 键 词：鼻咽癌 同期放化疗 诱导化疗 

分 类 号：R739.63[医药卫生—肿瘤]