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中国癌症防治杂志

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放化疗综合治疗局部中晚期鼻咽癌的疗效观察

韦燕;龚建忠;赵善琳;陈彦帆;   

  1. 广西医科大学第八附属医院肿瘤科;
  • 收稿日期:2009-06-25 修回日期:2009-06-25 出版日期:2009-06-25 发布日期:2009-06-25

The effect of comprehensive treatment with radiotherapy and chemotherapy in locally advanced nasopharyngeal cancer

WEI Yan,GONG Jian-zhong,ZHAO Shan-lin,et al.   

  1. (Department of oncology,the Eighth Affiliated Hospital of Guangxi Medical University,Guigang Guangxi 537100,China
  • Received:2009-06-25 Revised:2009-06-25 Online:2009-06-25 Published:2009-06-25

摘要: 目的探讨诱导化疗+辅助化疗配合放疗综合治疗局部中晚期鼻咽癌的临床疗效和患者的耐受性。方法于2003年2月至2005年7月,应用PF方案诱导化疗1周期后3~7d开始行鼻咽癌常规根治性放疗,放疗结束后1w再予以PF方案化疗3个周期,化疗方案:DDP 30mg/m~2,静脉滴入,d1~d3;5-FU 500mg/m~2,静脉滴入,d1~d5,21d为1个周期,观察综合治疗的疗效和患者的耐受性。结果治疗后3、6个月鼻咽原发病灶完全缓解率分别为95.6%和95.6%,颈部淋巴结完全缓解率分别为93.3%和97.8%。3年总生存率为80%,无进展生存率为73.3%。主要毒副反应为Ⅰ~Ⅱ度消化道反应。Ⅰ~Ⅱ度骨髓抑制发生率较高,主要是白细胞下降,口腔黏膜反应为Ⅰ~Ⅱ级,患者均能耐受。结论诱导化疗+辅助化疗配合放疗综合治疗局部中晚期鼻咽癌的疗效较满意,毒副反应可以耐受,治疗依从性较好。

关键词: 中晚期鼻咽癌, 放疗, 诱导化疗, 辅助化疗

Abstract: Objective To explore the clinical efficacy of comprehensive treatment with radiotherapy and chemotherapy in locally advanced nasopharyngeal cancer(NPC),and the tolerability of patients.Methods From February 2003 to July 2005,patients with locally advanced NPC were initially treated with one cycles of induction chemotherapy with PF program(DDP 30mg/m~2·day,continuous infusion on days 1~3;5-fluorouracil 500 mg/m~2·day,continuous infusion on days 1~5;21 days as a cycl e). The conventional radical radiotherapy started 3~7 days after one cycle of PF induction chemotherapy program,and followed by three cycles of PF chemotherapy program.The clinical efficacy and tolerability of the patients were observed.Results the complete remission rates of nasopharyngeal primary lesions at 3 and 6 months after the treatment were 95.6%and 95.6%respectively, and the complete remission rates of neck lymph node were 93.3%and 97.8%respectively.The 3-year overall rate was 80% and disease-free survival rate was 73.3%.The main toxic side effects were gradeⅠ~Ⅱgastrointestinal reaction,gradeⅠ~Ⅱmyelosuppression and gradeⅠ~Ⅱoral mucositis.All the patients were well tolerated.Conclusions The clinical efficacy of induction chemotherapy plus adjuvant chemotherapy combined with radiotherapy in treating locally advanced NPC is quite satisfactory.The toxicity can be tolerated well and the treatment compliance is good.

Key words: Advanced nasopharyngeal carcinoma, Induction chemotherapy