摘要
目的:探讨放疗联合奈达铂周同步化疗治疗中晚期鼻咽癌的疗效。方法收集病理证实为鳞癌的局部中晚期鼻咽癌(T3-4期)153例的临床资料,其中72例行单纯放疗(简称单放组),81例行放疗联合奈达铂周同步化疗(简称联合组)。放疗方法相同:开始采用面颈联合野和下半颈切线野常规分割,DT36Gy后鼻咽部采用适形放射治疗和全颈切线野放疗,鼻咽部剂量70~72Gy,颈部淋巴结阳性者剂量65~70Gy,淋巴结阴性者剂量60~65Gy。联合组在放疗同时每周同步给予奈达铂化疗。结果治疗结束后第6、12个月,鼻咽部原发灶完全缓解率(CR):单放组为分别为70.83%(51/72)、56.94%(41/72),联合组分别为85.16%(69/81)、80.25%(65/81), P<0.05;治疗结束后第6、12个月颈部淋巴结完全缓解率(CR):单放组分别为为79.03%(49/62)、69.35%(43/62),联合组分别为92.75%(64/69)、86.96%(60/69),P<0.05;单放组和联合组1、2、3年生存率分别为80.56%(58/72)、70.83%(51/72)、44.45%(32/72)和93.83%(76/81)、86.42%(70/81)、80.25%(65/81),P<0.05。不良反应轻,经对症处理后均能完成放化疗。结论放疗联合周同步奈达铂化疗治疗中晚期鼻咽癌疗效较好,不良反应较少,患者耐受性好。
Objective:To investigate therapeutic ef ect of radiotherapy combining weekly concurrent chemotherapy with nedaplatin to treat advanced nasopharyngeal carcinoma(NPC).Methods:The data of 153 patients with advanced T-stage(T3-4)NPC confirmed by pathology was col ected.72 cases were suf ered with radiotherapy alone(RT Group).81 cases were suf ered with radiotherapy combining weekly concurrent chemotherapy with nedaplatin(CRT Group).Identical radiotherapy mode was adopted to al cases.The first period radiotherapy were administered DT36Gy with conventional face neck combining field and hypo-neck tangential field.Fol owing,al the patients were administered DT70-72Gy with conformal therapy in pharynx nasalis,and neck tangential field radiotherapy DT65-70Gy to positive neck lymph node,DT60-65Gy to negative lymph node.CRT Group was suf ered radiotherapy combining weekly concurrent chemotherapy with nedaplatin.Results:After 6,12months of treatment,the complete response(CR)rate of the pharynx nasalis focus of infection in RT group was 70.83%(51/72)and 56.94%(41/72),it was 85.16%(69/81)and 80.25%(65/81)in CRT group,respectively,P<0.05.The CR rate of neck lymph node in RT group was 79.03%(49/62)and 69.35%(43/62),it was 92.75%(64/69)and 86.96%(60/69)in CRT group,respectively,P<0.05.Survival rate of 1,2,3 years in CR group and CRT group were 0.56%(58/72),70.83%(51/72),44.45%(32/72)and 93.83%(76/81),86.42%(70/81),80.25%(65/81),respectively,P<0.05.The adverse reaction was regarded slightly.Conclusions:Radiotherapy combining weekly concurrent chemotherapy with nedaplatin to treat advanced nasopharyngeal carcinoma(NPC)was regarded bet er therapeutic ef ect than alone radiotherapy.And toxicity reactions could be tolerant.
作者
赵彩霞
胡欣
潘荣强
陈思林
李婷婷
ZHAO Cai-xia;HU Xin;PAN Rong-qiang;CHEN Si-lin;LI Ting-ting(Nanchong City Central Hospital Department of Tumor,Nanchong Central Hospital,Nanchong Sichuan 637000,China)
关键词
鼻咽癌
放疗
化疗
奈达铂
同期
Nasopharyngeal carcinoma(NPC)
Radiotherapy
Chemotherapy
Nedaplatin
Concurrent
