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中国癌症防治杂志

中国癌症防治杂志

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Ⅲ、Ⅳa期鼻咽癌同步放化疗联合辅助化疗的疗效观察

钟伟铭;梁锦辉;高健全;蔡永林;   

  1. 广西梧州市红十会医院肿瘤放疗科;梧州市肿瘤防治研究所;
  • 收稿日期:2010-06-25 修回日期:2010-06-25 出版日期:2010-06-25 发布日期:2010-06-25

Efficacy of concurrent chemoradiotherapy combined with adjuvant chemotherapy on the nasopharyngeal carcinoma at stage Ⅲ、Ⅳa

ZHONG Wei-ming,LIANG Jin-hui,GAO Jian-quan,et al.   

  1. (Department of Radiation Oncology,Wuzhou Red Cross Hospital,Wuzhou Cancer Research Institute,Guangxi 543002,China
  • Received:2010-06-25 Revised:2010-06-25 Online:2010-06-25 Published:2010-06-25

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被引次数

18

摘要： 目的探讨同步放化疗联合辅助化疗对Ⅲ、Ⅳa期鼻咽癌的疗效。方法选取108例Ⅲ、Ⅳa期鼻咽癌,分为同步放化疗联合辅助化疗组54例(研究组)和单纯放疗组54例(对照组),两组放疗方法相同。研究组于放疗前给予DDP30mg/m2,d1～3;5-FU750mg/m2,d1～3。化疗结束1～3d开始放疗。放疗第4周结束给予第2程化疗,放疗不间断,共2个疗程。辅助化疗于放疗结束后1～4w开始,3～4w重复1疗程,连用2个疗程。结果研究组和对照组5年总生存率、无瘤生存率、远处转移率分别为63.0%和42.6%(P=0.034)、61.1%和38.9%(P=0.021)、18.5%和37.0%(P=0.032)。在N3患者中,研究组和对照组的远处转移率分别为57.1%(4/7)和66.7%(4/6)(P=1.000)。3级毒性反应主要表现为口咽黏膜炎,研究组和对照组分别为48.1%和27.8%(P=0.029)。结论同步放化疗联合辅助化疗可提高Ⅲ、Ⅳa期鼻咽癌的5年总生存率和无瘤生存率,减少远处转移率,但对N3患者远处转移率未显示优势。

关键词: 鼻咽癌, 同步放化疗

Abstract: Objective To evaluate the efficacy of concurrent chemoradiotherapy combined with adjuvant chemotherapy on the patients with nasopharyngeal carcinoma(NPC)at stage III-IVa.Methods 108 patients with NPC at stage III-IVa were randomly divided into two groups.Test group(n=54)was treated with DDP 30mg/m2 and 5-FU 750mg/m2 on day 1-3;radiotherapy started 1-3 days after the end of first phase chemotherapy;the next two phases of chemotherapy were from 5th-week to the end of radiotherapy;adjuvant chemotherapy were performed after 1-4 weeks at the end of radiotherapy and repeated for 2 cycles.Control group(n=54)was treated only with conventional radiotherapy.Results The 5-year overall survival rate and disease-free survival rate were significantly higher in test group than that in control group(63.0% vs 42.6%,61.1% vs 38.9%,P<0.05).The rate of distant metastasis was significantly lower in test group than that in control group(18.5% vs 37.0%,P<0.05).Among the patients at stage N3,the rates of distant metastasis in test group and control group were 57.1%(4/7)and 66.7%(4/6)respectively(P=1.000).The test group experienced significantly more mucositis than that in control group(48.1% vs 27.8%,P<0.05).Conclusions Concurrent chemoradiotherapy combined with adjuvant chemotherapy could improve the 5-year overall survival rate and disease-free survival rate of NPC patients at stage III~IVa,and could reduce the rate of distant metastasis except the patients at stage N3.

Key words: Nasopharyngeal carcinoma, Concurrent chemoradiotherapy, Adjuvant chemotherapy