【摘要】 目的:探讨化学粒子(中人氟安)配合放疗治疗以鼻咽癌为主的头颈鳞癌的临床疗效及毒性反应。方法:94例头颈鳞癌首发患者随机分为中人氟安粒子植入+放疗组(SIRT)48例和单纯放疗组(RT)46例。SIRT组患者于放疗开始同时在瘤内植入中人氟安60～80 mg/点,单点给药量不超过100 mg;RT组患者只接受单纯放疗作为对照;两组放疗剂量和方法相同。结果:治疗4周后,SIRT组和RT组肿瘤平均缩小率分别为(76.7±15.2)%和(54.8±10.7)%,两组比较,差异有非常显著性(t=8.023,P<0.01);治疗8周后,两组肿瘤平均缩小率分别为(97.2±5.8)%和(84.3±20.1)%,两组比较,差异有非常显著性(t=4.272,P<0.01)。治疗4周后和12周后,两组肿瘤CR率分别为16.7%和2.2%(χ2=5.699,P<0.05)和89.6%和60.9%(χ2=10.479,P<0.05),两组比较,差异均有显著性。全组患者未见感染、出血、神经损伤等并发症。结论:间质化疗在瘤内可持久保持较高药物浓度并降低了系统毒性反应,实现了靶点给药的目的,应用于头颈鳞癌放射治疗中,明显增强了疗效,患者耐受性良好,临床使用安全、方便,未见不良反应,有着广阔的发展前景。更多还原

【Abstract】 Objective:To study the clinical curative effect and toxicity reaction of head and neck squamous carcinoma mostly to NPC(27/48),and treated by combined Sinofuan on intro-tumor injection and radiotherapy.Methods: Ninty-four cases of head and neck squamous carcinoma were confirmed by pathology,all cases were randomly divided into two grpups;Sinofuan intro-tumor implanting with radiotherapy group(SIRT)(48 cases) and radiotherapy group(RT)(46 cases).The Sinofuan in intro-tumor were implanted to the patients of SIRT group,which were given 60～80 mg/each point,and the dosage of single point did not exceed 100 mg,while radiotherapy simultaneously;ones of RT group only received radiotherapy as comparison.The dosages and methods of radiotherapy were same in each group,from January 2004 to August 2007.Results: Tumor average reduction rate in SIRT and RT group respectively was(76.7±15.2)% and(54.8±10.7)%(t=8.023,P<0.01) after 4 weeks in treatment,(97.2±5.8)% and(84.3±20.1)%(t=4.272,P<0.01) after 8 weeks in treatment.Total tumor disappearing rate(CR) of SIRT and RT group after 4 weeks and 12 weeks was respectively 16.7% and 2.2%(χ2=5.699,P<0.05),89.6% and 60.9%(χ2=10.479,P<0.05),they had statistic difference.Of these SIRT patients,no complications such as infection,bleeding,nerve injures happened.Conclusion:The clinical application keeps higher medication concentration,reduces systemic toxicity reaction,reaches the aim of implanting drugs into target points and significantly increases the effects in radiotherapy of head and neck squamous carcinoma.It is propitious to patients in the safety,convenience,good tolerance in Sinofuan and wider developing foreground.更多还原