【摘要】 目的:观察放疗联合替吉奥治疗中晚期鼻咽癌的临床疗效与不良反应。方法:选取2008年3月至2011年3月,武汉大学人民医院肿瘤中心45例经过病理组织学诊断为鼻咽部鳞状细胞癌的Ⅲ期或Ⅳ期患者并随机分为单纯放疗组(单放组)和放化疗组,放疗总剂量DT(68-72)Gy/30f,5次/周,颈淋巴结剂量为(56-70)Gy/(5.5-7)周,2Gy/f。同步口服替吉奥胶囊化疗(40mg/m2,2次/d,口服,连服28d,42d为1个周期,放疗结束后继续化疗2个周期)。结果:全组患者均完成治疗,依从性好,毒副反应轻。单放组CR率为60.87%,放化疗组CR率为90.91%,两组比较具统计学意义(P<0.05)。不良反应为放化组恶心呕吐反应发生率高,主要是轻中度,差异有统计学意义(P<0.05);放化疗组骨髓抑制较单放组明显(P<0.05);放化组皮肤反应无明显加重(P>0.05),但Ⅲ、Ⅳ度口腔黏膜反应发生率高,与单放组比较差异有统计学意义(P<0.05)。结论:局部放疗同步替吉奥化疗治疗晚期鼻咽癌的疗效确切,毒副反应可耐受,能明显改善患者的生活质量。更多还原

【Abstract】 Objective:To observe the effect of radiotherapy combined with S-1 chemotherapy for the treatment of patients with advanced nasopharyngeal carcinoma.Methods: From March 2008 to March 2011,45 cases whose pathological diagnosis were squamous cell carcinoma of the nasopharynx and stage Ⅲ or Ⅳ from Cancer Center,Renmin Hospital of Wuhan University were randomly divided into the radiotherapy alone group and radiochemotherapy group.The total radiation dose was(68-72) Gy/30f,5 times/week,cervical lymph node dose was 56-70Gy/5.5-7 weeks,2Gy/f.Synchronized oral S-1 chemotherapy(40mg/m2,2 times/d,orally,42d was a cycle,when radiotherapy finished,patients continued to under went the chemotherapy after two cycles).Results: All patients completed the treatment.Toxicity effect was small,and compared with 23 cases with radiotherapy alone,radiotherapy alone group CR rate was 60.87%,radiochemotherapy group CR rate was 90.91%(P<0.05).Treatment toxicity: nausea and vomiting had a high incidence in radiochemotherapy group,the majority was at light or middle,the difference was statistically significant(P<0.05);myelosuppressive in radiochemotherapy group compared with radiotherapy alone group was significantly(P<0.05);radiochemical group had no significant increase of skin reactions(P> 0.05),but Ⅲ,Ⅳ degree of the high incidence of oral mucositis,compared with radiotherapy alone group,the difference was statistically significant(P<0.05).Conclusion: Synchronous radiotherapy chemotherapy for advanced nasopharyngeal carcinoma was effective,toxicity can be tolerated,can significantly improve patients’ quality of life.更多还原