诱导化疗联合同期放化疗治疗Ⅲ、Ⅳ_a期鼻咽癌的临床研究  

Clinical study of induction chemotherapy plus concurrent radiochemotherapy in the treatment of stage Ⅲ and Ⅳ_a advanced nasopharyngeal carcinoma

作　　者：董超[1] 任艳鑫[2] 杨润祥[1] 任宏轩[1] 

机构地区：[1]昆明医科大学第三附属医院肿瘤内二科,云南昆明650118 [2]昆明医科大学第三附属医院头颈外科,云南昆明650118

出　　处：《现代肿瘤医学》2014年第11期2576-2579,共4页Journal of Modern Oncology

基　　金：云南省教育厅科学研究基金项目(编号:09Y0172)

摘　　要：目的:评价单纯放疗和诱导化疗联合同期放化疗治疗Ⅲ、Ⅳa期鼻咽癌的毒副反应、临床疗效和对生存期的影响。方法:统计2000年至2005年我院诊治的Ⅲ、Ⅳa期鼻咽癌患者169例,其中113例患者接受单纯根治性放疗(对照组);56例患者接受长春瑞滨(NVB)联合顺铂(DDP)诱导化疗2周期后行根治性放疗,同期给予DDP每周方案化疗(研究组)。两组患者进行临床疗效和毒副反应的比较,Kaplan-Meier法计算5年生存率和无瘤生存率。结果:研究组的鼻咽肿瘤和颈淋巴结完全消退率优于对照组(92.9%vs80.5%,85.7%vs 72.6%,P<0.05)。研究组和对照组的5年生存率和无瘤生存率分别为71.7%、61.3%和56.6%、47.6%,差异有统计学意义(P<0.05)。研究组毒副反应增加,以骨髓抑制、胃肠道反应和口腔黏膜炎为主。结论:诱导化疗联合同期放化疗可提高局部晚期鼻咽癌的临床疗效和生存率;毒副反应较大,但不影响治疗进程。Objective：To evaluate the efficacy and toxicity of radiotherapy alone and induction chemotherapy plus concurrent chemoradiotherapy for stage Ⅲ and Ⅳa nasopharyngeal cancer（NPC） and to compare the influence on survival rates. Methods：To analyze clinical data of 169 locally advanced NPC patients from 2000 to 2005.56 cases were treated two cycles of induction chemotherapy followed by conventional radical radiotherapy and concurrent weekly cisplatin chemotherapy （study group） ;113 were treated with radiotherapy alone （control group）. The therapeutic response and adverse reaction of the two groups were compared. The 5 - year overall and disease - free survival rates were ana- lyzed by Kaplan - Meier. Results： Complete response rates of the nasopharyngeal control and the cervical lymph nodes control in study group were superior to that in control group（92.9% vs 80.5% ,85.7% vs 72.6% ,P 〈0.05）. The 5 - year overall survival rates in study group and control group were 71.7% and 56.6% respectively. The disease - free survival rates in two groups were 61.3% and 47.6%. The 5 - year overall and disease - free survival rates were significantly higher in study group than in control group （P 〈 0.05 ）. The rates of toxicity effect in study group were higher than in control group. The main toxicity was hematological toxicties, gastrointestinal reaction and oral mucositis. Conclusion：The induction chemotherapy plus concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma could improve the therapeutic response and survival rates. Though toxicity effects were serious, the progress of treatment would not be influced.

关 键 词：鼻咽肿瘤 诱导化疗 同期放化疗 生存分析 

分 类 号：R739.62[医药卫生—肿瘤]