摘要
目的探讨诱导化疗联合后程超分割放疗在中晚期鼻咽癌治疗中的应用价值。方法126例III、IVa期鼻咽癌被随机分为诱导化疗联合后程超分割放疗组(治疗组)64例和常规放疗组(对照组)62例,治疗组先行二个周期PF/CF方案化疗,常规分割放疗剂量达40Gy后改为超分割放疗。对照组采用常规分割放疗。结果原发病灶和颈部转移病灶对化疗均有较高的反应率(有效率分别为79.7%和81.3%;治疗组颈部淋巴结CR率高于对照组(p<0.05);治疗组1、3、5年生存率和无瘤生存率似高于对照组,但统计学处理差异不显著。治疗组复发率明显低于对照组(p<0.05),平均复发时间明显长于对照组(p<0.001)。远处转移情况两组相似。治疗组急性放射反应明显大于对照组,但远期后遗症发生率相似。结论大剂量PF/CF方案诱导化疗联合后程超分割放疗能提高局部控制率,有可能提高中晚期鼻咽癌的远期生存率,治疗中急性放射反应明显加重,但未增加远期后遗症发生率。二个周期化疗未能减少远处转移率。
Objective To explore the value of induction chemotherapy in combination with Late course hyperfractionation radiotherapy in the treatment of advanced nasopharyngeal carcinoma. Methods 126 cases of nasopharyngeal carcinoma in Ⅲ or Ⅳa stage were randomized to induction chemotherapy in combination with Late course hyperfractionation radiotherapy group with 64 patients （experimental group） and conventional Irradiation group with 62 patients （control group）. For those patients in experimental group, 2 courses of PF/CF regimen were instituted at first. Then conventional fractionated radiotherapy was given. When the total dose of irradiation reached 40Gy the method of radiotherapy was changed to hyperfractionation radiotherapy. Results The response rate for both the primary and the metastatic lesions were 79.7% and 81.3% respectively; The CR of neck lymph nodes in the experimental group was higher than that in the control group （p〈0. 05）; The 1-year, 3-year and 5-year survival rate and disease-free survival rate in the experimental group were higher than those in the control group, however, the differences were not statistically significant. The relapse rate in＇the experimental group is lower than that in the control group （P〈0.05）; The mean time to relapse in the experimental group was longer than that in the control group （P〈0. 001）; The rate of distant metastasis and the mean time to metastasis were similar in both group. Although the rate acute side effects of irradiation were more severe in the experimental group, the rate of long term side effects was similar in both groups. Conclusion High dose PF/CF regimen in combination with Late course hyperfractionation radiotherapy is able to increase the control rate of local lesions of nasopharyngeal carcinoma. It seems to improve the long term survival of nasopharyngeal carcinoma patients with intermediated or advanced diseases. Ahhough the acute side effects of irradiation in this regimen are more severe, the rate of long term side effects does not elevate. Two cycles of chemotherapy do not reduce the rate of distant metastasis.
出处
《国际医药卫生导报》
2005年第18期11-13,共3页
International Medicine and Health Guidance News
关键词
鼻咽肿瘤
化学疗法
放射疗法
后程超分割
Nasopharyngeal carcinoma Chemotherapy Radiotherapy Late course hyperfractionation radiotherapy
