同步放化疗对晚期鼻咽癌患者生存预后的影响分析  

Effect of concurrent radiotherapy and chemotherapy on the prognosis of patients with locally advanced nasopharyngeal carcinoma

作　　者：张定富[1] 吴秋芳[1] 戈长征[1] 徐炎华[1] 

机构地区：[1]荆州市中心医院肿瘤科,湖北荆州434020

出　　处：《现代医学》2017年第1期75-78,共4页Modern Medical Journal

摘　　要：目的:探讨同步放化疗治疗局部晚期鼻咽癌(LA-NPC)患者的临床效果及对患者预后的影响。方法:选取2009年至2012年收治的87例LA-NPC患者作为研究对象,根据治疗方式分为联合组(46例)和放疗组(41例),联合组采用放疗联合化疗的方法,放疗组仅采用单纯放疗治疗。结果:治疗后,联合组完全缓解率为39.13%,高于放疗组的19.52%(P<0.05);血清CD44及唾液酸水平均低于放疗组(P<0.05);患者中位生存时间为33.5个月,长于放疗组患者的30.7个月(Log-rankχ~2=3.792,P=0.042);Ⅱ+Ⅲ度口腔黏膜炎发生率为30.43%,Ⅱ+Ⅲ度放射性皮炎发生率为26.07%,Ⅱ+Ⅲ度恶心呕吐发生率为30.43%,高于放疗组的12.21%、14.63%、9.76%,差异均具有统计学意义(P<0.05)。结论:同步放化疗治疗LA-NPC患者有利于进一步提高治疗效果、延长患者的生存期,但是不良反应发生率较高。Objective To investigate the effect of concurrent radiotherapy and chemotherapy in the treatment of patients with locally advanced nasopharyngeal carcinoma （LA-NPC） and its effect on the prognosis of patients. Methods Selected 87 LA-NPC patients treated in our hospital from 2012 to 2009 were selected as the study subjects. The treatment was divided into 46 cases of the combined group and 41 cases in the radiotherapy group, the combined group was treated with radiotherapy combined with chemotherapy, radiotherapy group was treated with radiotherapy alone. The short term clinical effect, long-term prognosis and adverse reaction of the two groups were compared.Results Joint group of CR rate was 39.13% significantly higher than radiotherapy group 19.52% and the difference was statistically significant （P 〈 0.05）. Before treatment and in the combination group and control group of serum CD44 and SA levels were had no statistical significance （P 〉 0.05）. After treatment, combined group of serum CD44 and SA levels significantly lower than radiotherapy group （P 〈 0.05）; Joint group of 3 years survival rate 80.43% （37/46） and the control group 70.73% （29） differences without statistical significance （χ^2 =1.115, P=0.291〉0.05）; Patients in the combination group bit survival time of 33.5 months significantly longer than radiotherapy in patients with 30.7 months （log rank χ^2=3.792, P=0.042〈0.05. The incidence of combined group II ＋ III degree of oral mucositis 30.43%, II ＋ III of radioactive dermatitis was 26.07%, II ＋ III degree of nausea and vomiting occurrence rate was 30.43% were significantly higher than in the radiation group 12.201%, 14.63%, 9.76%, the difference has statistical significance （P 〈 0.05）.Conclusion Synchronous radiotherapy and chemotherapy in the treatment of LA-NPC is beneficial to further improve the treatment effect, prolong the survival time of patients, but the incidence of adverse reactions is higher.

关 键 词：同步放化疗 局部晚期鼻咽癌 临床效果 预后 

分 类 号：R739.63[医药卫生—肿瘤]