放化疗联合治疗局部晚期鼻咽癌的临床研究

发布时间：2018-06-16 01:41

本文选题：局部晚期鼻咽癌 + 诱导化疗　；参考：《临床耳鼻咽喉头颈外科杂志》2014年06期

【摘要】：目的:探讨放化疗交替疗治疗局部晚期鼻咽癌的临床疗效。方法:回顾性分析106例局部晚期鼻咽癌患者临床资料。单纯放疗15例;91例接受PF方案为基础的诱导化疗和(或)辅助化疗,其中诱导化疗加放疗加辅助化疗36例,诱导化疗加放疗25例,放疗加辅助化疗30例。诱导化疗1~2周期,辅助化疗3~6周期。放疗于诱导化疗结束后第1天进行,辅助化疗在放疗结束后1周开始进行。鼻咽原发灶采用60 Co,常规分割照射68~74Gy,颈部根治量60~70Gy,颈部预防量48~50Gy,每组均完成根治量放疗。结果:中位随访时间51个月,58例患者死亡,全组总生存率为45.3%。单纯放疗、诱导化疗加放疗加辅助化疗、诱导化疗加放疗、放疗加辅助化疗的5年总生存率分别为33%、63%、60%、50%,无瘤生存率分别为13%、56%、48%、40%,无局部复发率分别为13%、53%、48%、50%,无远处转移率分别为6%、50%、44%、47%,均差异有统计学意义(P0.05)。各组发生复发、转移的中位时间分别为22、29、28、25个月;10、19、15、12个月,均差异无统计学意义(P0.05)。诱导化疗加放疗加辅助化疗组急性毒性反应较其他组重,但未影响治疗进程,患者均可耐受。结论:诱导化疗和辅助化疗联合尽早开始的放疗治疗局部晚期鼻咽癌疗效较好,不良反应轻,适合局部晚期鼻咽癌患者的综合治疗。
[Abstract]:Objective: to investigate the clinical effect of alternate radiotherapy and chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods: the clinical data of 106 patients with locally advanced nasopharyngeal carcinoma were retrospectively analyzed. Only 15 cases of radiotherapy were treated with induced chemotherapy and / or adjuvant chemotherapy based on PF regimen, including 36 cases of induced chemotherapy plus radiotherapy plus adjuvant chemotherapy, 25 cases of induced chemotherapy plus radiotherapy, and 30 cases of radiotherapy plus adjuvant chemotherapy. Induction chemotherapy was 1 ~ 2 cycles and adjuvant chemotherapy was 3 ~ 6 cycles. Radiotherapy was performed on the first day after induced chemotherapy, and adjuvant chemotherapy began 1 week after radiotherapy. Nasopharynx primary focus was treated with 60 Co. conventional fractionation irradiation was performed at 68m 74 Gy, neck radical cure was 6070 Gy, neck prophylaxis was 480.50 Gy, and radiotherapy was completed in each group. Results: the median follow-up time was 51 months and 58 patients died. The overall survival rate was 45.3%. Radiotherapy alone, induction chemotherapy plus radiotherapy plus adjuvant chemotherapy, induction chemotherapy plus radiotherapy, The 5-year overall survival rate of radiotherapy plus adjuvant chemotherapy was 330.The tumor-free survival rate was 135.56 and 48m, respectively. The local recurrence rate was 13535348and 50cm, respectively, and the non-distant metastasis rate was 60.500.The difference was statistically significant (P 0.05). The median time of recurrence and metastasis in each group was 2229 / 28, 1019 / 15 and 12 / 12, respectively. There was no significant difference between the two groups (P 0.05). The acute toxicity of induced chemotherapy plus radiotherapy plus adjuvant chemotherapy was more severe than that of other groups, but it did not affect the course of treatment. Conclusion: induction chemotherapy combined with adjuvant chemotherapy combined with early radiotherapy is effective in treating locally advanced nasopharyngeal carcinoma with mild adverse reactions and is suitable for comprehensive treatment of locally advanced nasopharyngeal carcinoma.
【作者单位】：重庆医科大学附属第一医院耳鼻咽喉-头颈外科;
【基金】：国家自然科学基因(No:30901661)
【分类号】：R739.63

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