鼻咽癌同步放化疗的研究进展

发布时间：2018-02-02 22:02

本文关键词： 鼻咽癌放射治疗三维适形放疗适形调强放疗图像引导放疗容积调强放疗同步放化疗　出处：《蚌埠医学院》2015年硕士论文　论文类型：学位论文

【摘要】：背景:我国是世界各大洲中鼻咽癌的高发地区之一。由于鼻咽部位较深,且鼻咽周围有许多重要血管神经,颈淋巴结和远处器官转移率高,使得手术治疗受到限制,目前鼻咽癌公认有效的治疗手段为放疗。早期的鼻咽癌患者采用单纯放射治疗有较理想的效果,中晚期患者由于较高的局部复发率和远处转移率导致总生存率明显降低。同步放化疗作为一种综合治疗的方式,已成为鼻咽癌的常规治疗手段。本文就目前鼻咽癌同步放化疗的研究进展情况进行综述。目的:通过阅读国内外近年来鼻咽癌同步放化疗的相关文献,从鼻咽癌同步放化疗的理论依据、临床疗效、同步放化疗中放疗技术的进展、同步放化疗中化疗时间和方案的选择及同步放化疗的毒副作用几个方面来研究鼻咽癌同步放化疗的临床治疗优势和缺陷,以进一步提高对鼻咽癌同步放化疗的认识,寻求更加合理规范且疗效最佳的同步放化疗方案,以期进一步改善患者的生存及预后。方法:使用中国知网、万方数据库、Pubmed检索系统,以“鼻咽癌;放射治疗;三维适形放疗;适形调强放疗;图像引导放疗;容积调强放疗;同步放化疗”做为关键词,分别及联合检索文献。综合分析研究符合研究目的的52篇国内外文献。结果:大量临床研究结果显示出同步放化疗在鼻咽癌治疗中有着无可比拟的优势,多数文献显示其能提高局部控制率和总生存率、减少远处转移、降低复发,虽然毒副反应增加,但多数患者尚可耐受。结论:同步放化疗在鼻咽癌的治疗中显示了无可比拟的优势,放疗技术的不断进步和越来越多新兴化疗药物的出现为同步放化疗开拓了广阔的前景,但仍然缺少一个标准的放化疗联合模式,如何进一步提高同步放化疗的临床疗效和减轻其毒副反应,达到进一步提高鼻咽癌患者生存质量和预后的目的,还有待更多的大样本临床试验加以完善。
[Abstract]:Background: China is one of the regions with high incidence of nasopharyngeal carcinoma on every continent in the world. Because of the deep nasopharynx and many important vessels and nerves around the nasopharynx, the cervical lymph node and distant organ metastasis rate is high. At present, radiotherapy is considered to be an effective treatment for nasopharyngeal carcinoma. Radiotherapy alone in early nasopharyngeal carcinoma patients has an ideal effect. The overall survival rate was significantly decreased due to the high local recurrence rate and distant metastasis rate in the middle and late stage patients. Simultaneous radiotherapy and chemotherapy as a comprehensive treatment. It has become a routine treatment for nasopharyngeal carcinoma. This article reviews the progress of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma. Objective: to review the literature on simultaneous radiotherapy and chemotherapy of nasopharyngeal carcinoma at home and abroad in recent years. According to the theoretical basis of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma, the clinical efficacy, and the progress of radiotherapy in simultaneous radiotherapy and chemotherapy. To study the advantages and disadvantages of simultaneous radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC), the selection of time and scheme of chemotherapy and chemotherapy and the side effects of concurrent radiotherapy and chemotherapy were used to study the advantages and disadvantages of simultaneous radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC). In order to further improve the understanding of nasopharyngeal carcinoma synchronous radiotherapy and chemotherapy, to seek a more reasonable standard and the best curative effect of simultaneous radiotherapy and chemotherapy regimen, in order to further improve the survival and prognosis of patients. Wanfang database, Pubmed search system, was used to "nasopharyngeal carcinoma (NPC);" Radiotherapy; Three dimensional conformal radiotherapy; Conformal intensity modulated radiotherapy; Image guided radiotherapy; Volume intensity modulated radiotherapy; Simultaneous radiotherapy and chemotherapy as a key word. Results: a large number of clinical studies showed that simultaneous radiotherapy and chemotherapy had unparalleled advantages in the treatment of nasopharyngeal carcinoma. Most literature shows that it can improve the local control rate and overall survival rate, reduce distant metastasis, reduce recurrence, although the side effects increased. Conclusion: simultaneous radiotherapy and chemotherapy have unparalleled advantages in the treatment of nasopharyngeal carcinoma. The continuous progress of radiotherapy technology and the emergence of more and more new chemotherapeutic drugs have opened up a broad prospect for simultaneous radiotherapy and chemotherapy, but there is still a lack of a standard combination mode of radiotherapy and chemotherapy. How to further improve the clinical efficacy of concurrent radiotherapy and chemotherapy and reduce its toxicity and side effects to further improve the quality of life and prognosis of patients with nasopharyngeal carcinoma, there are still more large samples of clinical trials to be improved.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R739.63

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