根治性调强适形放疗联合同期化疗治疗转移性鼻咽癌效果分析  

Efficacy analysis of radical intensity-modulated radiotherapy combined with concurrent chemotherapy for treatment of metastatic nasopharyngeal carcinoma

作　　者：潘雅[1] 黄家军 黄继红[1] 苏炳泽[1] 王海妹[1] 陈赛明 王晓凤[1] Pan Ya;Huang Jiajun;Huang Jihong;Su Bingze;Wang Haimei;Chen Saiming;Wang Xiaofeng(Department of Otolaryngology,the First Affiliated Hospital of Hainan Medical University,Haikou 570203,China)

机构地区：[1]海南医学院第一附属医院耳鼻喉科,海口570203

出　　处：《肿瘤研究与临床》2018年第6期400-403,共4页Cancer Research and Clinic

摘　　要：目的 探讨根治性调强放疗联合同期化疗治疗转移性鼻咽癌的临床疗效.方法 选择2010年8月至2015年4月海南医学院第一附属医院诊治的转移性鼻咽癌患者90例作为研究对象,采用随机信封抽签法分为观察组与对照组,每组45例.对照组采用传统化疗治疗,观察组在对照组治疗的基础上给予根治性调强放疗,两组均治疗4个周期后评价患者疗效.结果 观察组的治疗有效率为66.7 %（30/45）,高于对照组的33.3 %（15/45）（χ2=4.552,P＜0.05）.观察组中发生放射性食管损伤、肺损伤各3例,发生率为13.3 %（6/45）,经过对症处理后好转.治疗期间观察组的脱发、恶心、呕吐、肝肾损伤、骨髓抑制不良反应的发生率为71.1 %（32/45）,对照组为66.7 %（30/45）,两组比较差异无统计学意义（χ2=0.331,P＞0.05）.所有患者都得到随访,观察组的1年及2年生存率为95.6 % （43/45）、86.7 %（39/45）,均高于对照组的75.6 %（34/45）、64.4 %（29/45）（χ2值分别为6.393、5.309,均P＜0.05）.结论 根治性调强放疗联合同期化疗治疗转移性鼻咽癌能提高疗效,且安全性较好,其导致的放射性损伤不会影响治疗进程.Objective To investigate the clinical effects of radical intensity-modulated radiotherapy （IMRT） combined with concurrent chemotherapy in the treatment of metastatic nasopharyngeal carcinoma. Methods Ninety patients with metastatic nasopharyngeal carcinoma in the First Affiliated Hospital of Hainan Medical University from August 2010 to April 2015 were selected as the research objects. All the patients were randomly divided into the observation group （45 cases） and the control group （45 cases） according to the random lottery envelope. The control group was treated with conventional chemotherapy treatment, and the observation group was treated with radical IMRT based on the treatment of the control group. The efficacy of the patients in both groups was evaluated after the treatment for 4 periods. Results The effective rate in the observation group was higher than that in the control group [66.7 % （30/45） vs. 33.3 % （15/45）; χ2= 4.552, P〈 0.05]. In the observation group, there were 3 cases of radiation esophageal injury and 3 cases of lung injury, and the incidence rate was 13.3 % （6/45）, bringing the better treatment outcome. The incidence of side effects such as hair loss, nausea and vomiting, liver and kidney damage, bone marrow suppression in the observation group was 71.1 % （32/45）, which was higher than that in the control group [66.7 % （30/45）] and there was no significant difference （χ 2= 0.331, P〉 0.05）. All the patients were followed up. 1 yeas and 2 year survival rates in the observation group were 95.6 % （43/45） and 86.7 % （39/45） respectively, while the control group were respectively 75.6 % （34/45） and 64.4 % （29/45） （χ2values were 6.393 and 5.309, both P〈0.05）. Conclusion Radical IMRT combined with concurrent chemotherapy for metastatic nasopharyngeal carcinoma can improve the therapeutic effect and show good safety, and the radiation damage would not affect the treatment process.

关 键 词：鼻咽肿瘤 肿瘤转移 放射疗法 调强适形 药物疗法 联合 放射性损伤 

分 类 号：R739.63[医药卫生—肿瘤]