【摘要】 目的观察多西他赛联合顺铂诱导化疗后三维适形调强放疗同步化疗对局部晚期鼻咽癌的疗效。方法300例局部晚期鼻咽癌患者随机分为同步放化疗组(CCRT)和诱导化疗加同步放化疗组(ICCRT),ICCRT组先进行2个周期的多西他赛联合顺铂诱导化疗后再进行同步放化疗,CCRT组仅进行2个周期的多西他赛联合顺铂化疗,在此基础上,所有患者均进行三维适形调强放疗。比较两组患者近期疗效、局部控制率、无转移生存率、不良反应及相关功能。结果ICCRT组患者的近期疗效、局部控制率、无转移生存率、生理评分和生活质量评分均高于CCRT组患者,差异具有统计学意义(P<0.05)。ICCRT组和CCRT组均出现不同程度放射性食管炎、放射性肺炎、中性粒细胞减少、血红蛋白减少、恶心呕吐、口腔黏膜反应等,但差异无统计学意义(P>0.05)。结论多西他赛与顺铂的联合诱导化疗后同步放化疗治疗局部晚期鼻咽癌可明显提高临床疗效、局部控制率、无转移生存率,不良反应较轻,是治疗局部晚期鼻咽癌的可行方案。更多还原

【Abstract】 Objective To observe the effect of docetaxel and cisplatin induction chemotherapy before concurrent chemotherapy and three-dimensional conformal adjusting radiotherapy for locally advanced nasopharyngeal carcinoma. Methods 300 patients with locally advanced nasopharyngeal carcinoma patients were randomly divided into concurrent radiotherapy and chemotherapy group( CCRT) and induction chemotherapy plus concurrent radiotherapy and chemotherapy( ICCRT) group. Patients in ICCRT group first received 2 cycles of docetaxel combined with cisplatin induction chemotherapy followed by concurrent chemoradiotherapy,and patients in CCRT group received only 2 cycles of concurrent chemoradiotherapy. On this basis,all patients received three-dimensional conformal intensity modulated radiation therapy. The short-term efficacy,local control rate,non-metastatic survival rate,adverse reactions and correlation function were compared between the 2 groups. Results The short-term efficacy,local control rate,non-metastasis survival rate,physiological score and quality of life score in ICCRT group were higher than those of CCRT group,there had statistically significant difference( P < 0. 05). Patients in ICCRT group and CCRT group both showed different degrees of radiation esophagitis and pneumonitis,neutrophil cells decreased,decreased hemoglobin,nausea,vomiting,oral mucosa reaction and other adverse reactions,but there had no statistically significant difference( P > 0. 05). Conclusion Docetaxel combined with cisplatin induction chemotherapy before concurrent chemotherapy and three-dimensional conformal adjusting radiotherapy for locally advanced nasopharyngeal carcinoma can significantly improve the curative effect,local control rate and metastasis free survival,with lighter adverse reactions,it is a feasible plan for locally advanced nasopharyngeal carcinoma.更多还原