【摘要】 目的　探讨化疗加放疗治疗N2 、N3 期鼻咽癌的价值。方法　 86例N2 、N3 期鼻咽癌随机分为放化组和单放组 ,两组放疗均采用60 Cor线常规分割照射 ,鼻咽部剂量为 6 8～ 70Gy/ 6 .8～ 7周 ,颈部淋巴结转移灶剂量为 6 6～ 76Gy/ 6 .6～ 7.6周。放化疗组在放疗第 1周和第 5周行CF +5 Fu +DDP化疗 2周期。结果　放化疗组和单放组近期鼻咽部肿瘤完全消退率分别为93.0 %和 86 .0 % (P >0 .0 5 ) ;颈部淋巴结转移灶完全消退率为 86 .0 %和 6 5 .1 % (P <0 .0 5 )。两组 3、5年鼻咽部肿瘤控制率分别是 6 7.4 %和 4 4 .2 % (P <0 .0 5 ) ,5 5 .9%和 37.2 % (P <0 .0 5 ) ;两组颈部淋巴结转移灶控制率分别是 6 5 .1 %和 4 1 .9% (P <0 .0 5 ) ,5 8.1 %和 37.2 % (P <0 .0 5 ) ;两组 3、5年的远处转移率分别是 2 0 .9%和 4 1 .9% (P <0 .0 5 ) ,2 7.9%和 4 8.9% (P <0 .0 5 ) ;两组 3、5年生存率分别是 5 8.1 %和 34.9% (P <0 .0 5 ) ,4 6 .5 %和 2 5 .6 % (P <0 .0 5 )。放化组的消化道反应、血液毒性均高于单放组 (P <0 .0 5 ) ,但病人可以耐受。结论　同步放化疗治疗N2 、N3 期鼻咽癌有助于提高生存率 ,减少局部复发和远处转移更多还原

【Abstract】 Objective To evaluate the value of chemotherapy with radiotherapy in N 2,N 3 stage nasopharyngeal carcinoma.Methods Eighty six cases with N 2,N 3 stage nasopharyngeal carcinoma were randomized into two groups:chemoradiotherapy(A) and radiotherapy alone(B).Both of two groups received radiotherapy with 60 Co r ray which was delivered with conventional fractionation,a radical dose with 68 70 Gy/6.8～7w in nasopharynx and 60 76 Gy/6～7.6w in neck.Group A received two cycles of the chemotherapy with CF,5 Fu and DDP in the first and the fifth week of radiotherapy.Results The primary tumor control rates of group A and group B at 3 and 5 year were 67.4% to 44.2%( P <0.05)and 55.9% to37.2( P <0.05) respectively.The cervical lymph node control rates at 3 and 5 year were 65.1% to 41.9%( P <0.05)and 58.1% to37.2%( P <0.05),and the distant metastatic rates were 20.9% to 41.9( P <0.05) and 27.9% to 48.9%( P <0.05) respectively.The 3 and 5 year survial rates were 58.1 % to 34.9%( P <0.05),and 46.5% to 25.6%( P <0.05).Conclusion Radiotherapy with chemotherapy can increase the survival rates and decrease the distant mestasis in patients with N 2,N 3 stage nasopharyngeal carcinoma.更多还原