中危鼻咽癌单纯调强放疗对比顺铂同期放化疗的临床研究  

Clinical study of intensity-modulated radiation therapy alone versus concurrent chemoradiotherapy for moderate-risk nasopharyngeal carcinoma

作　　者：叶祯开[1] 卢耀振[1] 陈艳[1] 谭琛 韦周吉 唐洁 YE Zhenkai;LU Yaozhen;CHEN Yan;TAN Chen;WEI Zhouji;TANG Jie(Department of Radiotherapy,Minzu Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院放疗科,广西南宁530001

出　　处：《中国现代医生》2022年第16期5-9,共5页China Modern Doctor

基　　金：广西壮族自治区崇左市科技计划项目(崇科攻2018012)。

摘　　要：目的 探讨中危鼻咽癌单纯调强放疗对比顺铂同期放化疗的临床价值。方法 收集2019年1月~2020年4月在广西壮族自治区民族医院初治的40例中危鼻咽癌(T1-2N1/T2-3N0)患者,随机分为单纯放疗组(RT组,n=20)、同期放化疗组(CCRT组,n=20),放疗方式均为调强放疗(intensity-modulated radiation therapy,IMRT)。评价两组患者的近期疗效、毒性反应、生活质量及治疗后1年的生存状况。结果 两组患者鼻咽部及淋巴结肿瘤治疗前后疗效比较,差异无统计学意义(P>0.05);CCRT组口咽黏膜反应、白细胞反应、胃肠道反应、脱发反应等毒性反应明显高于RT组(P<0.05);治疗后两组患者的生活质量在总体健康状况、躯体功能、角色功能、疲倦、疼痛等评分明显高于治疗前(P<0.05),另外,CCRT组治疗后在情绪功能、恶心呕吐、失眠、食欲不振等评分较治疗前明显升高(P<0.05),两组治疗前后的总体健康状况评分比较,差异有统计学意义(P<0.05);两组1年后LRRFS、OS、PFS、DRFS比较,差异无统计学意义(P>0.05)。结论 中危鼻咽癌(Ⅱ期及T3N0)患者调强放疗加入化疗无明显疗效优势,但急性毒性反应大,患者依从性低,生活质量差。Objective To investigate the clinical value of intensity-modulated radiation therapy alone versus concurrent chemoradiotherapy for moderate-risk nasopharyngeal carcinoma. Methods Forty patients with moderate-risk nasopharyngeal carcinoma(T1-2N1/T2-3N0) who were initially treated in the Minzu Hospital of Guangxi Zhuang Autonomous Region from January 2019 to April 2020 were randomly divided into the radiotherapy alone group(RT group,n=20) as the study group and the concurrent chemoradiotherapy group(CCRT group,n=20) as the control group.The radiotherapy methods were intensity-modulated radiation therapy(IMRT).The short-term efficacy, toxic reaction, quality of life and survival status 1 year after treatment were mainly evaluated in the two groups. Results There was no significant difference in the efficacy of nasopharyngeal and lymph node tumors before and after treatment between the two groups(P>0.05). The oropharyngeal mucosal reaction, white blood cell reaction, gastrointestinal reaction, alopecia and other toxic reactions in the CCRT group were significantly greater than those in the RT group(P<0.05). After treatment, the scores of quality of life in the overall health status, physical function, role function,fatigue,pain,etc. in the two groups were significantly higher than those before treatment(P<0.05).In addition, the scores of emotional function, nausea and vomiting,insomnia,loss of appetite,etc. in the CCRT group after treatment were significantly higher than those before treatment(P<0.05). There was significant difference in the overall health status score before and after treatment between the two groups(P<0.05). There was no significant difference in 1-year LRRFS, OS, PFS and DRFS between the two groups.Conclusion IMRT combined with chemotherapy has no obvious therapeutic effect on intermediate-risk nasopharyngeal carcinoma(stage II and T3N0),but it has high acute toxic reaction. The patient’s compliance is low, and the quality of life is poor.

关 键 词：中度风险 鼻咽癌 调强放疗 同期放化疗 

分 类 号：R730.5[医药卫生—肿瘤]