【摘要】 目的:比较放、化疗与单纯放射治疗鼻咽癌的生存率、局部控制率、远处转移发生率和毒副反应。方法:从1991年4月至1993年10月,126例N2、N3期(92分期)鼻咽癌患者随机分为放、化疗组和单纯放疗组。放、化疗组放疗前、中或放疗后用PDD+5-FU化疗一个疗程,化疗方案:PDD20mg/m21～5天,5-FU500mg/m21～5天。两组放疗方法相同,全部病例用8MV光子线或60Co外照射,鼻咽部剂量为65～70Gy/6.5～7周。颈淋巴转移灶剂量为65～70Gy/6.5～7周。结果:放、化疗组和单放组鼻咽肿瘤完全消退率分别为93.6%和85.7%(P>0.05),颈部转移淋巴结完全消退率为84.1%和57.1%(P<0.05)。CT扫描检查鼻咽肿瘤完全消退率为71.4%和50.8%(P<0.05),两组3、5年生存率分别为68.3%和52.4%(P>0.05)、50.8%和38.1%(P>0.05);3、5年鼻咽部肿瘤控制率分别为71.4%和57.1%(P<0.05)、68.3%和47.6%(P<0.05)。颈部转移淋巴结控制率分别为69.8%和52.3%(P<0.05),63.5%和42.9%(P<0.05);3、5年发生远处转移率分别为20.6%和39.7%(P<0.05),23.8%和47.6%(P<0.05)。放、化疗组口腔炎、恶心、呕吐较单放组多见且明显(P<0.05),放、化疗组血液毒性大于单放组(P<0.05),但可接受。结论:放、化疗治疗N2、N3期鼻咽癌有助于提高局部控制率和减少远处转移。更多还原

【Abstract】 Objective:Nasopharyngeal carcinoma (NPC)is a radiosensitive tumor,it has a high local control rate after radical radiotherapy(RT).However,for patients with local advanced disease,the rate of distant metastasis is high and the5-year survival rate is poor.This study is designed to determine the absolute survival of NPC patients treated with radiation alone and as compared to that of patients receiving chemoradiation.Methods:From April1991to October1993,126patients with histologically proven NPC(stage N 2 N 3 )were randomized into two groups:Group A(63cases)were treated with radiotherapy combined with chemotherapy receiving radio-therapy of65～70Gy /6.5～7w to the nasopharyngx and65～70/6.5～7w to neck and receiving2～3cycles of chemotherapy of PF protocol(5-FU and cisplatin).Group B(63cases)received the same radiotherapy alone.Results:The primary tumor control rate of group A and group B at3-and5-year were71.4%to57.1%(P<0.05)and68.3%to47.6%(P<0.05)respectively.The cervical lymph node control rate at3-,5-year were69.8%to52.3%(P<0.05)and63.5%to42.9%(P<0.05),and the distant metastatic rate were20.6%to39.7%(P<0.05)and23.8%to 47.6%(P<0.05)respectively.The distant metastasis in group A was lower than that of group B.Conclusion:Radiotherapy combined with chemotherapy may increase the local disease control and may lower the distant metastasis in patients with N 2 N 3 advanced stage NPC.更多还原