诱导化疗联合同期放化疗治疗Ⅲ、Ⅳa期鼻咽癌地临床研究.docVIP

PAGE PAGE 1诱导化疗联合同期放化疗治疗Ⅲ、Ⅳa期鼻咽癌的临床研究 董超1，任艳鑫2，杨润祥1，庄莉1，任宏轩1(1.昆明医科大学第三附属医院肿瘤内二科，2.头颈外科 云南昆明 650118)摘要：目的 评价单纯放疗和诱导化疗联合同期放化疗治疗Ⅲ、Ⅳa期鼻咽癌的毒副反应、临床疗效和对生存期的影响。方法 统计2000年至2005年我院诊治Ⅲ、Ⅳa期鼻咽癌患者169例，其中113例患者接受单纯根治性放疗（对照组）， 56例患者接受NVB联合DDP诱导化疗2周期后行根治性放疗，同期给予DDP每周方案化疗（研究组），两组患者进行临床疗效和毒副反应的比较，Kaplan-Meier法计算5年生存率和无瘤生存率。结果 研究组的鼻咽肿瘤和颈淋巴结完全消退率优于对照组（92.8% vs 80.5%，85.7% vs72.6% P<0.05）。研究组和对照组的5年生存率和无瘤生存率分别为71.70% vs 、61.3% 和 56.6% vs 、47.6％。，差异有统计学意义（P<0.05）。研究组毒性反应增加，以骨髓抑制、胃肠反应和口腔黏膜炎为主。结论 诱导化疗联合同期放化疗可提高局部晚期鼻咽癌的临床疗效和生存率。毒副反应较大，但不影响治疗进程。关键词: 鼻咽肿瘤;　诱导化疗;同期化放疗;生存分析Clinical study of Induction Chemotherapy Plus Concurrent Radiochemotherapy in the Treatment of stage Ⅲ and Ⅳa advanced Nasopharyngeal CarcinomaDONG Chao，REN Yan-xin，YANG Run-xiang，Zhuang Li，REN Hong-xuan.1.Dapartment of the second medical oncology,The Third Affiliated Hospital of Kunming Medical University ,Kunming 650018，China；2. Dapartment of head and neckAbstract：objective To evaluate the efficacy and toxicity of radiotherapy alone and induction chemotherapy plus concurrent chemoradiotherapy for stageⅢand Ⅳa nasopharyngeal cancer(NPC) and to compare the influence on survival rates.Methods To analysis clinical datas of 169 locally advanced NPC patients from 2000 to 2005. 56 cases were treated two cycles of induction chemotherapy followed by conventional radical radiotherapy and concurrent weekly cisplatin chemotherapy (study group)； 113 were treated with radiotherapy alone(control group). The therapeutic response and adverse reaction of the two groups were compared.The 5-year overall and disease-free survival rates were analyzed by Kaplan-Meier.Results the complete response rates of the nasopharyngeal control and the cervical lymph nodes control in study group were superior to that in control group(92.8%vs80.5%，85.7%vs72.6% P<0.05). The 5-year overall survival rates in study group and control group were 71.7% and 56.6% respectively.The disease-free survival rates in two groups were 61.3% and 47.6％。The 5-year overall a