【摘要】 观察顺铂、阿霉素同期化放疗治疗局部晚期鼻咽癌的疗效及毒副反应 ,探讨该方案的临床可行性。方法 :32例T3～4N2～3M0 局部晚期鼻咽癌患者进入综合治疗组 ,分别在放疗第1、22、43d接受顺铂70mg/m2 +阿霉素30mg/m2 同期化疗 ,化疗当天及第二天水化利尿。另配对选取32例单纯放疗者为对照组。结果 :所有病例如期完成治疗。放疗40Gy 时 ,综合组颈淋巴结有效率较高 (P<0 05) ;放疗结束5～6周后 ,综合组颈淋巴结完全缓解率较单纯放疗组明显提高(P<0 05) ;鼻咽肿瘤缓解率也有所提高 ,但无统计学意义 (P>0 05)。毒性反应主要表现综合组比单纯放疗组更多发生Ⅰ、Ⅱ级骨髓抑制、胃肠道反应和脱发 ;两组所发生的皮肤及粘膜反应相当。结论 :顺铂 +阿霉素同期化放疗 ,可明显提高晚期鼻咽癌患者颈淋巴结转移灶局控率 ,对鼻咽原发灶的控制也有一定帮助 ;对其毒性反应患者可耐受 ,未影响放疗的顺利完成 ,是鼻咽癌综合治疗的可行方法 ,值得进一步观察研究更多还原

【Abstract】 Objective: To observe and evaluate the result of treatment with concurrent cisplatin(DDP), adriamycin(ADM) and radiotherapy for the local advanced nasopharynegal carcinoma Methods: From May 1997 to August 1999, 32 patients with local advanced nasopharyngeal carcinoma (groupⅠ) were treated with DDP and ADM combined with simultaneous standard radiotherapy, in which DDP (70 mg/m2) and ADM (30 mg/m2) were intravenously given every 3 weeks for threecourses Another 32 patients (group Ⅱ) chosen from the same period or historyand matched with the groupⅠin sex,age,karnofsky performance scale, and clinical stage were treated with standard radiotherapy alone Results: All patientshad completed the treatment plans At 40 Gy of radiotherapy, the partial response rate of lymph node metastases in groupⅠwas higher than that in groupⅡ(P<0 05) And at 5～6 weeks after radiotherapy the complete response rate of the metastases of lymph nodes in groupⅠsignificantly was also higher than thatin growth Ⅱ(P<0 05) However the increase of the complete response rate ofthe nasopharyngeal tumor was not significant(P>0 05) in groupⅠas comparing with groupⅡ The major side effects in growth were mild leukopenia, nausea, vomiting, and alopecia Conclusion: Chemo radiotherapy combined with DDP, ADM and concurrent radiotherapy may be better for the patients with local advanced nasopharynegal carcinoma, especially for lymph node metastases and needs to be further studied and evaluated in randomized trial更多还原