诱导化疗与同期化疗对局部晚期鼻咽癌患者远期疗效的对比研究

发布时间：2018-06-24 01:06

本文选题：鼻咽肿瘤 + 放射治疗　；参考：《临床耳鼻咽喉头颈外科杂志》2017年05期

【摘要】：目的:探讨诱导化疗与同期化疗对局部晚期鼻咽癌患者的远期疗效及安全性。方法:以2006-01-2011-01期间收治的190例符合研究标准的鼻咽癌患者为研究对象,其中接受诱导化疗加放疗者92例,为诱导组;接受同期放化疗加辅助化疗者98例,为同期组。对比分析2组患者的一般资料、总生存率、无进展生存率、急慢性不良反应等,并分析局部晚期鼻咽癌的预后不良因素。结果:诱导组和同期组5年无进展生存率(70.7%、67.3%,P=0.591)和总生存率(78.3%、78.6%,P=0.635)均差异无统计学意义。2组复发或转移率差异无统计学意义(29.3%、35.7%,P=0.435)。与同期组相比,诱导组Ⅲ~Ⅳ级白细胞减少及恶心呕吐的发生率明显更低,差异有统计学意义(均P0.05);2组间晚期不良反应的发生率差异无统计学意义(P0.05)。多因素分析结果显示年龄(P=0.000)和N分期(P=0.003)是局部晚期鼻咽癌患者总生存率的独立预后影响因素。结论:诱导化疗加放疗与同期放化疗加辅助化疗对局部晚期鼻咽癌患者的疗效相当,且诱导化疗加放疗相关的急性不良反应发生率低。因此,诱导化疗加放疗可能是更为有效、安全的治疗方式。
[Abstract]:Objective: to investigate the long-term efficacy and safety of induction chemotherapy and concurrent chemotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods: 190 patients with nasopharyngeal carcinoma (NPC) admitted from January to January 2011 were included in the study. 92 patients received induction chemotherapy plus radiotherapy as induction group, 98 patients received radiotherapy and adjuvant chemotherapy at the same time. The general data, overall survival rate, progression-free survival rate, acute and chronic adverse reactions were compared between the two groups, and the prognostic factors of locally advanced nasopharyngeal carcinoma were analyzed. Results: there was no significant difference in 5-year progression-free survival rate (70.7%) and overall survival rate (78.3%) and total survival rate (78.3%) between the induction group and the same group (P 0.635). There was no significant difference in the recurrence or metastasis rate between the two groups (29.3%, 35.7g, P0.435). Compared with the same group, the incidence of leucopenia and nausea and vomiting in the induced group was significantly lower than that in the same group (P0.05). There was no significant difference in the incidence of late adverse reactions between the two groups (P0.05). Multivariate analysis showed that age (P0. 000) and N stage (P0. 003) were independent prognostic factors for the overall survival rate of patients with locally advanced nasopharyngeal carcinoma. Conclusion: induction chemotherapy plus radiotherapy is the same as radiotherapy plus adjuvant chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma, and the incidence of acute adverse reactions associated with induced chemotherapy and radiotherapy is low. Therefore, induction chemotherapy plus radiotherapy may be a more effective and safe treatment.
【作者单位】：潍坊市益都中心医院耳鼻咽喉科;潍坊市益都中心医院中医科;
【分类号】：R739.63

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