【摘要】 目的:探讨患者对联合应用诱导化疗和放疗同期口服卡莫氟治疗中晚期鼻咽癌疗效和毒副反应。方法:将66例局部中晚期鼻咽癌患者,随机分为诱导化疗随后放疗组33例(对照组)和诱导化疗随后放疗同期卡莫氟治疗组33例(治疗组)。两组放疗方法相同,鼻咽部剂量70Gy/(35次.7周),颈部淋巴结根治量为(60~70Gy)/[(30-35次).(6~7)周]。治疗组在放疗期间同时口服卡莫氟,200mg/次,3次/d。结果:诱导化疗效率高,平均有效率高达87.0%,其中平均CR8.7%,PR78.4%。治疗组白细胞下降Ⅲ~Ⅳ级(18.2%)高于对照组(13.1%),χ2=6.6,P=0.010。治疗组口腔黏膜炎Ⅲ~Ⅳ级发生率(63.6%)高于对照组(30.3%),χ2=7.360,P=0.007。治疗组恶心发生率(87.9%)高于对照组(39.4%),χ2=16.762,P=0.0001,经对症处理大部分患者能按计划完成治疗。结论:初步研究结果提示放疗同期口服卡莫氟治疗局部中晚期鼻咽癌有潜在性的增益,其远期疗效有待于进一步观察。更多还原

【Abstract】 OBJECTIVE: To study the impact of induction chemotherapy (ICT) followed radical radiotherapy alone(RT) and radiotherapy concomitant HCFU chemotherapy (RTCHC) on the locoregional control and metastasis and acute toxicity in patients with nasopharyngeal carcinoma (NPC). METHODS: Sixty-six newly diagnosed patients with Stage Ⅲ and Ⅳ NPC were recruited onto two randomized tials, namely, thirty-three patients for RT, and the others for RTCHC. The nasopharyngeal tumor dose was 70 Gy delivered in 35 fractions, the cervical nodal metastasis dose 60-70 Gy delivered in 30-35 fractions. HCFU was taken orally 200 mg t.i.d. in the course of radiotherapy for RTCHC. RESULTS: After two circles of induction chemotherapy, the average rate of overall nasopharyngeal tumor and cervical nodal disease were 87.8% and 8.7% for CR, 78.4% for PR. The incidences of Ⅲ to Ⅳ grade of leukocytopenia, mucitis of oral cavity and nausea in study group were 18.2%, 63.6%, 87.9%, and more than those in the control group of 13.1%,30.3%, 39.4%,and there were statistic differences (χ2=6.6,P=0.010; χ2=7.360,P=0.007; χ2=16.762,P=0.000 1) However, they were able to endure. CONCLUSIONS: The induction chemotherapy followed by radiotherapy concomitant HCFU chemotherapy is effective in patients with local advanced NPC. This single institution experience deserves further investigation in prospective trials.更多还原