【摘要】 目的　观察化、放疗加生物反应调节剂 (BiologicalresponsemodifierBRM )的综合治疗对Ⅱ期以上的鼻咽癌(NasopharygealCarcinomaNPC)的疗效。 方法　 6 0例按 1992年全国鼻咽癌福州会议推荐的分期标准为Ⅱ期以上的鼻咽癌患者 ,随机分为综合治疗组 (化、放疗加生物反应调节剂组 )和单纯放疗组 ;综合治疗组在放疗前先予以化疗 :5 氟脲嘧啶 (5 Flurouracil ,5 Fu) 10 0 0mg/日 ,连续 3天 ,顺铂CisplatinDDP) 2 0mg/日 ,连续 3天 ,或 5 Fu 5 0 0mg/日 ,连续 5天 ,DDP2 0mg/日 ,连续 5天 ,BRM采用oK4 32 ,5KE/次 /3日 ,共 3～ 4次 ,部分病人加用抗鼻咽癌免疫核糖核酸 (i RNA) 5 0mg至 90mg ;休息 3～ 7天开始放疗 ,两组放疗剂量、方法相同 ,放射源为60 Cr线。结果　综合治疗组和单纯放疗组放疗结束后 2个月 ,原发灶和颈淋巴结消退率分别为 93 .3 %、70 .0 %和 96 .7%、70 .0 % (P <0 .0 5 )。综合治疗组的主要毒性反应为骨髓抑制、胃肠道反应及口腔粘膜急性反应 ,但病人均能耐受 ,但不影响治疗的序贯实施。结论　放疗联合 5 Fu、DDP及ok4 32 ,有利于Ⅱ期以上鼻咽癌原发灶及颈淋巴转移灶的全消率并减少残存 ,是治疗鼻咽癌的有效方法之一 ,是否提高生存率 ,有待进一步研究证实更多还原

【Abstract】 Objective A prospective study was conducted to assess the preliminary results of chemo radiotherapy plus biological response modifier(BRM) for nasopharyngeal carcinoma(NPC) above Ⅱ stage.Methods Sixty patients with histologically proven NPC above Ⅱ stage were randomized into two groups,comprehensive group including 30 cases received one course of chemotheray with cisplatin(D.D.P) and 5 Fluorouracil (5 Fu) before radiotherapy and ok 432 or Anti NPCiRNA during radiotherapy;3～7 days after chemotherapy,radotherapy was given 68～73GY of radiation on nasopharynx and 68～70Gy on neck. Radiotherapy group received the same radiotherapy as the comprehensive group.Results 2 months after treatment,for primary tumour in nasopharynx effective rates of comprehensive and radiotherapeutic group were 93.3% and 70.0%,and for lymphatic metastases in neck were 96.7% and 70.0%,respectively,with significant difference between two groups(P<0.05).The side effect was myelosuppression, acute oral mucosal injury and gastrointestinal reaction in comprehensive group which were tolerable by the patients.Conclusions Chemoradiotherapy plus biological response modifier leads to improved curability of nasopharyngeal carcinoma above Ⅱ stage.更多还原