诱导化疗加放疗与同期放化疗治疗局部晚期鼻咽癌的疗效比较

发布时间：2018-01-14 18:36

本文关键词：诱导化疗加放疗与同期放化疗治疗局部晚期鼻咽癌的疗效比较　出处：《中国肿瘤》2016年05期 　论文类型：期刊论文

【摘要】：[目的]比较诱导化疗加放疗与同期放化疗治疗局部晚期鼻咽癌的疗效。[方法]收集2007年1月至2009年12月中山大学附属肿瘤医院收治的经病理证实的局部晚期鼻咽癌258例,其中采用顺铂+5-Fu诱导化疗加调强放疗(诱导组)128例,采用顺铂同期放化疗(同期组)130例。应用Kaplan-Meier和Log-rank方法计算和比较两组患者的生存率,应用COX风险回归模型进行预后多因素分析。[结果]诱导组和同期组5年总生存率(83.1%vs 83.0%)、无瘤生存率(80.9%vs 79.1%)、无转移生存率(84.9%vs 83.6%)、无复发生存率(95.0%vs 92.8%)比较差异均无统计学意义(P0.05)。同期组3、4级恶心呕吐的发生率明显高于诱导组(10%vs1.6%,P=0.004),体重下降的平均数也明显大于诱导组(P0.001)。多因素分析结果显示N分期是影响局部晚期鼻咽癌总生存的独立因素。[结论]诱导化疗加调强放疗治疗局部晚期鼻咽癌的疗效与同期放化疗相近,但同期放化疗的消化道反应较重。远处转移是局部晚期鼻咽癌治疗失败的主要原因。
[Abstract]:[Objective] to compare the efficacy of induction chemotherapy plus radiotherapy with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. [Methods from January 2007 to December 2009, 258 cases of locally advanced nasopharyngeal carcinoma (NPC) were treated in affiliated Cancer Hospital of Sun Yat-sen University. Among them, 128 cases were treated with cisplatin 5-Fu induced chemotherapy plus intensity-modulated radiotherapy (induction group, n = 128). Kaplan-Meier and Log-rank were used to calculate and compare the survival rate of the two groups. COX risk regression model was used for multivariate analysis of prognosis. [Results] the 5-year overall survival rate was 83.1 vs 83.0 in the induction group and the same time group, and the tumor-free survival rate was 80.9 vs 79.1). There was no significant difference in metastasis free survival rate (84.9% vs 83.6%), recurrence free survival rate (95.0% vs 92.8%). The incidence of nausea and vomiting in grade 4 was significantly higher than that in the induction group (10 vs 1.6 and P 0.004). The average weight loss was significantly higher than that in the induction group (P 0.001). The results of multivariate analysis showed that N stage was an independent factor affecting the overall survival of locally advanced nasopharyngeal carcinoma (NPC). [Conclusion: the therapeutic effect of induction chemotherapy plus intensity-modulated radiotherapy on locally advanced nasopharyngeal carcinoma is similar to that of concurrent radiotherapy and chemotherapy, but the digestive tract reaction of chemotherapy and radiotherapy at the same time is more serious, and distant metastasis is the main cause of failure in the treatment of locally advanced nasopharyngeal carcinoma.
【作者单位】：中山大学肿瘤防治中心华南肿瘤学国家重点实验室肿瘤医学协同创新中心;
【分类号】：R739.63
【正文快照】： 世界新发鼻咽癌患者中71%位于东亚、东南亚,尤其是中国华南地区[1]。其中60%~70%患者初诊时即被确诊为局部晚期鼻咽癌[2],治疗失败模式主要是局部复发和远处转移。目前中晚期鼻咽癌的标准治疗为同期放化疗加辅助化疗,研究[3,4]显示,不良反应标准第3版(CTCAE v3.0)。同期放

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