调强放疗联合化疗在局部晚期口咽癌治疗中的作用  

Role of intensity-modulated radiotherapy combined chemotherapy for locally advanced Oropharyngeal carcinoma

作　　者：姜翠红[1] 吴湘玮[1] 刘雯[1] 

机构地区：[1]湖南省肿瘤医院头颈放疗科,长沙410013

出　　处：《中国肿瘤临床与康复》2014年第11期1352-1355,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨调强放疗联合化疗治疗局部晚期口咽癌的临床效果。方法选取66例局部晚期口咽癌患者,随机分为观察组和对照组,每组33例。观察组患者给予调强放疗联合化疗,对照组患者给予常规放疗联合化疗,两组化疗方案相同。所有患者先接受1~2个周期紫杉醇＋顺铂（TP）方案诱导化疗,放疗开始后予以顺铂同步化疗。比较两组患者3年局部控制率（LRC）、无病生存率（DFS）、总生存率（OS）及不良反应发生率。结果 66例局部晚期口咽癌患者的1、3年生存率分别为94.0%和82.0%,其中观察组患者3年LRC、DFS和OS分别为97.0%、91.0%和94.0%,对照组患者分别为82.0%、76.0%和70.0%,差异有统计学意义（均P〈0.05）。观察组患者放射性皮炎和口腔干燥发生率明显低于对照组患者,差异有统计学意义（P〈0.05）。结论调强放疗联合化疗可提高局部晚期口咽癌患者的局部控制率、无病生存时间和总生存时间,有助于患者口咽功能的保护,改善患者生存质量,具有较好的临床效果和安全性,值得临床推广应用。Objective A prospective study for the Role of Intensity-modulated radiotherapy combined chemotherapy in locally advanced oropharyngeal carcinoma,to assess the feasibility of this methods.Methods From March 2009 to March 2010,66 patients with advanced oropharyngeal carcinoma were treated with radiotherapy,these patients were randomly divided into IMRT plus chemotherapy group（observation group） and CRT plus chemotherapy group（control group） with 33 cases in each.The method of chemotherapy of two groups were the same.All the patients received induction chemotherapy with 1 ~ 2 cycles TP（PTX ＋ DDP） regimen,DDP was used in concurrent radiochemotherapy.The local contral rate（LRC）,disease free survival（DFS）,overall survival（OS） and Adverse effects rate of the two groups were comparted.Results The 1,3-year overall survival rates were 94.0% and 82.0%.The local contral rate,disease free survival and overall survival were 82.0%,76.0% and 70.0% in the observation group,which were all higher than those of the control group（82.0%,76.0% and 70.0%,P 〈 0.05 for all）.The major toxic and side effects were myelosuppression,gastrointestinal reactions,acute radiation stomatitis,radiodermatitis and xerostomia.The incidence of III-IVradioermatitis reactions and xerostomia in observation group were lower than those in group B（P 〈 0.05）.Conclusion Intensity-modulated radiotherapy Combined Chemotherapy can not merely improve the efficacy of patients with locally advanced oropharyngeal carcinoma,but also keep the oropharyngeal function in patients and improve quality of life.

关 键 词：口咽肿瘤 调强放疗 药物疗法 

分 类 号：R739.63[医药卫生—肿瘤]