摘要
目的 :探讨同期化疗加放疗对中晚期鼻咽癌远期疗效的影响。方法 :88例Ⅲ、Ⅳa期鼻咽癌 (′92分期 )随机分为化疗加放疗组 (放化组 44例 )和单纯放疗组 (单放组 44例 )。单放组采用60 Co加 180kvX线常规分割 ,鼻咽部及颈切线用60 Co γ线 ,颈部垂直野用 180kvX射线。鼻咽部剂量 6 5— 78Gy ,颈部根治量 6 0— 72Gy ,残留病灶加 10Gy左右 ,放化组加用顺铂 (DDP)及氟尿嘧啶 (5 FU)化疗 3疗程 ,第一疗程在放疗前 1周 ,第二疗程在放疗 40Gy左右时 ,第三疗程放疗结合后 1个月进行。结果 :一、三、五年生存率放化疗组分别为 86 4%、77 3%、5 0 % ;单放组为79 5 %、6 8 2 %、40 9% ,两组比较无显著差异 (P >0 0 5 ) ,一、三、五年局控率放化疗组分别为 84 1%、6 8 1%、47 7% ,单放组分别为 81 8%、47 7%、38 6 % ,两组比较无显著差异 (P >0 0 5 )。放化疗组出现远处转移平均时间18 6个月 ,单放组 8 8个月 ,两组比较有显著差异 (P <0 0 5 )。结论 :同期DDP加 5 FU化疗未能提高局部中晚期鼻咽癌放疗的生存率、局控率 。
Purpose:A prospective study was conducted to study the influence of radiotherapy plus concurrent chemotherapy treatment on the longterm results for median and advaced nasopharyngeal carcinoma. Methods:88 cases diagnosed stage ⅢⅣ a nasopharyngeal carcinoma patients ('92 stage system), were randomized into two groups, ①Radiotherapy group(44cuses) who received only radiotherapy with 65—78 Gy (33—38F) in nasopharynx and 60—72 Gy (30—36F) in the neck. Booster radiotherapy 10 Gy (5F). ②Radiochemotherapy group (44 cases) received the same radiotherapy as the radiotherapy only group and three cycles of chemotherapy with cisplatin and 5 fluorouracil. The first cycle of chemotherapy was given one week before radiotherapy and the second was given after 40 Gy of radiotherapy and the third was given one month after completion of radiotherapy. Results:The 1、3、5 year survival rates were 86.4%、77 3%、50% respectively in radiochemotherapy group and 79.5%、68 2%、40 9% respectively in radiotherapy only group ( P >0 05). The 1、3、5 year local disease control rates in radiochemotherapy group were 88.6%、68 2%、47 7% respectively incontrast to 81.1%、47 7%、38 6% respectively in radiotherapy only group ( P >0 05). The average time of occurrence of distant metasttasis was 18.8 months in radiochemotherapy group and 8.8 months in radiotherapy ( P <0 05). Conclusions:Chemotherapy with DDP and 5 FU plus radiotherapy did not increase the survival rates and local disease control rates, but can delay the time of distant metastasis for stage Ⅲ、Ⅳ a nasopharyngeal carcinoma.
出处
《中国癌症杂志》
CAS
CSCD
2000年第2期136-138,共3页
China Oncology
关键词
鼻咽癌肿瘤
放射疗法
药物疗法
nasopharyngeal carcinoma
radiotherapy
chemotherapy
