放疗联合顺铂治疗晚期鼻咽癌的临床研究  

Prospective randomized trial in combined radiotherapy and cisplatin for advanced nasopharyngeal carcinoma(NPC)

作　　者：孙新东[1] 范晓丽[1] 韩俊庆[1] 梁超前[1] 田世禹[1] 于甬华[1] 

机构地区：[1]山东省肿瘤医院,济南250117

出　　处：《临床肿瘤学杂志》2001年第4期342-344,共3页Chinese Clinical Oncology

摘　　要：目的:观察放疗同时应用顺铂治疗鼻咽癌时放射增敏作用以及预防转移和提高生存情况.方法:75例晚期(Ⅲ、Ⅳ)鼻咽癌被随机分为两组:单纯放疗组(RT)37例,顺铂联合放疗组(RT+P)38例.鼻咽部均采用60Co或6MVx线常规外照射,总量为68～72Gy.颈部淋巴结转移灶采用60Co和12～9Mev电子线,肿瘤总量为60～74Gy(颈髓≤40Gy).RT+P组在放疗的开始日同时应用顺铂,每次40mg静滴,并给予适当水化和止吐药物,每周2次(周一、三给药),连用4周.结果:疗终鼻咽肿瘤全消率两组无差异,颈淋巴结转移灶全消率RT+P组高于RT组(P<0.05).低分化鳞癌、N2病灶全消时的平均放射剂量RT+P组低于RT组(P<0.05).3年内鼻咽部复发、颈部淋巴结复发及远处转移RT+P组均低于RT组,分别是10.5%、7.9%、15.8%和29.7%、27.0%、48.6%,均有显著性差异.3、5年生存率RT+P组、RT组分别是40.5%、24.3%和68.4%、47.4%(P<0.05).结论:放疗同时给予适量顺铂,具有一定增敏作用,并能抑制或延迟肿瘤复发及远处转移,从而提高晚期鼻咽癌患者的生存期.ve:To observe the radiosensitivityness and delay distant metastasis and improve the survival of combination radiotherapy with cisplatin (PDD) in treating patients with NPC. Methods: 75 advanced NPC ( Ⅲ、Ⅳ stage) patients were treated from April 1993 to August 1995. They had been randomized into two groups: radiotherapy alone in 37 patients (RT) and radiotherapy combinzed with PDD in 38 patients (RT+ P). The radiotherapy method was uniform in two groups, radiotherapy dose was 68 -72Gy/7-7.5w in the nasopharynx and 60-74Gy/6-7.5w in the cervical. PDD 40mg/f, 2f/w in RT+ P. Results:The complete response (CR) rate in the nasopharynx was similar in two groups. CR rate in the cervical metastasises was higher in RT+ P than in RT (P< 0.05) . The mean dose of radiation of CR was lower in RT + P than in RT when the cervical lymph metastasises were N2 and squamous cell carcinoma of poorly differentiated (P < 0.05 ) . The 3 - year relapse rate in the nasopharynx and the cervical lymph node were 10.5% and 7.9% in RT + P and 29.7% and 27.0% in RT(P<0.05), respectively. The 3 - year distant metastasis rate was 15.8% in RT+ P and 48.6% in RT(P<0.01), respectively. The 3 - year and 5 - year survival rates were 68.4% and 47.4% in RT+ P and 40.5% and 24.3% in RT(P < 0.05), respectively. Conclusions: It indicate that rational DDP combined with radiotherapy could increase radiosensitivityness and delay relapse and distant metastasis so that it could improve the long term survival.

关 键 词：鼻咽癌 顺铂 放射治疗 

分 类 号：R739.63[医药卫生—肿瘤]